Faecal tumour necrosis factor-alpha in individuals with HIV-related diarrhoea.

Abstract

OBJECTIVE:

HIV-related gastrointestinal infection is associated with diarrhoea, weight loss, mucosal inflammation and increased intestinal permeability. As tumour necrosis factor (TNF)-alpha may mediate these features this cytokine was measured in the faeces of HIV-seropositive individuals with diarrhoea to assess its role in the pathogenesis of HIV-related gastrointestinal disease and the association with specific intestinal pathogens.

DESIGN:

Prospective study.

METHODS:

Two hundred and four HIV-seropositive individuals provided stool samples that were analysed for faecal TNF-alpha (FTNF-alpha) using a standard sandwich enzyme-linked immunosorbent assay.

RESULTS:

Stool from patients with bacterial, cytomegalovirus (CMV) and microsporidial diarrhoea had significantly elevated FTNF-alpha compared with those who had pathogen-negative diarrhoea (P < 0.05). FTNF-alpha was not raised in cryptosporidiosis, pathogen-negative or solid stool. In subjects with diarrhoea of more than 2 weeks duration and three stool samples negative for enteric pathogens, FTNF-alpha greater than 15 U/ml has a sensitivity of 88% and a specificity of 66% for the diagnosis of diarrhoea-related CMV enteritis.

CONCLUSION:

TNF-alpha production may have a role in the pathogenesis of bacterial, microsporidial and CMV-related diarrhoea in HIV-seropositive individuals. Thus, anti-TNF-alpha agents may have a therapeutic role in the management of these conditions. FTNF-alpha greater than 15 U/ml in apparently pathogen-negative diarrhoea may suggest endoscopic gastrointestinal biopsy to diagnose CMV enteritis.

• Authors: D R Sharpstone, A W Rowbottom, M R Nelson, M W Lepper, B G Gazzard
• Journal: AIDS (London, England) (AIDS) Vol. 10 Issue 9 Pg. 989-94 (Aug 1996) ISSN: 0269-9370 [Print] England
• PMID: 8853732 (Publication Type: Journal Article)

Chemical References

• Tumor Necrosis Factor-alpha

Topics

• AIDS-Related Opportunistic Infections (metabolism, physiopathology)
• Diarrhea (etiology, metabolism)
• Feces
• HIV Infections (complications)
• Humans
• Prospective Studies
• Tumor Necrosis Factor-alpha (analysis)