Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus

Cecilia Mantegazza,1 Giovanni Maconi,2 Vania Giacomet,1 Federica Furfaro,2 Chiara Mameli,1 Cristina Bezzio,2 Michela Monteleone,2 Giulia Ramponi,1 Gian Vincenzo Zuccotti11Department of Paediatrics, 2Gastroenterology Unit, L Sacco University Hospital, Milan, ItalyBackground: The gastrointestinal tra...

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Autores principales:	Mantegazza C, Maconi G, Giacomet V, Furfaro F, Mameli C, Bezzio C, Monteleone M, Ramponi G, Zuccotti GV
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/e84fa04363ae4f5b81dc559a4f508887
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spelling	oai:doaj.org-article:e84fa04363ae4f5b81dc559a4f5088872021-12-02T05:34:31ZGut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus1179-1373https://doaj.org/article/e84fa04363ae4f5b81dc559a4f5088872014-05-01T00:00:00Zhttp://www.dovepress.com/gut-and-mesenteric-lymph-node-involvement-in-pediatric-patients-infect-a16734https://doaj.org/toc/1179-1373 Cecilia Mantegazza,1 Giovanni Maconi,2 Vania Giacomet,1 Federica Furfaro,2 Chiara Mameli,1 Cristina Bezzio,2 Michela Monteleone,2 Giulia Ramponi,1 Gian Vincenzo Zuccotti11Department of Paediatrics, 2Gastroenterology Unit, L Sacco University Hospital, Milan, ItalyBackground: The gastrointestinal tract is a primary target for human immunodeficiency virus (HIV). HIV infection causes a depletion of CD4+ T-lymphocytes in gut-associated lymphoid tissue and affects gastrointestinal mucosal integrity and permeability. The gastrointestinal tract has also been suggested as the main reservoir of HIV despite highly active antiretroviral therapy (HAART). We performed a prospective case-control study to assess gut involvement in HIV-infected patients, either naïve or on HAART, using noninvasive methods such as bowel ultrasound and fecal calprotectin.Methods: Thirty HIV-infected children and youth underwent the following tests: CD4+ T-cell count and HIV viral load, fecal calprotectin, and bowel ultrasound, with the latter evaluating bowel wall thickness and mesenteric lymph nodes. Fecal calprotectin and bowel ultrasound were also assessed in 30 healthy controls matched for age and sex. Fecal calprotectin was measured using a quantitative immunochromatographic point-of-care test, and concentrations ranging from 0 to 200 µg/g were considered to be normal reference values in children.Results: Fecal calprotectin was normal in 29 HIV-infected patients and was not significantly different from controls (mean values 63.8±42.5 µg/g and 68.3±40.5 µg/g, respectively; P=0.419), and did not correlate with HIV viral load, CD4+ T-cell absolute count and percentage, or HAART treatment. No significant changes were found on bowel ultrasound except for enlarged mesenteric lymph nodes, which were observed in seven HIV-infected patients (23.3%) and two controls (6.6%). This finding was significantly correlated with high HIV viral load (P=0.001) and low CD4+ T-cell percentage (P=0.004).Conclusion: HIV-infected children did not have significant biochemical or ultrasonographic signs of bowel inflammation. A few patients showed enlarged mesenteric lymph nodes, which correlated with uncontrolled HIV infection.Keywords: children, human immunodeficiency virus, fecal calprotectin, bowel ultrasoundMantegazza CMaconi GGiacomet VFurfaro FMameli CBezzio CMonteleone MRamponi GZuccotti GVDove Medical PressarticleImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol 2014, Iss default, Pp 69-74 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607
spellingShingle	Immunologic diseases. Allergy RC581-607 Mantegazza C Maconi G Giacomet V Furfaro F Mameli C Bezzio C Monteleone M Ramponi G Zuccotti GV Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus
description	Cecilia Mantegazza,1 Giovanni Maconi,2 Vania Giacomet,1 Federica Furfaro,2 Chiara Mameli,1 Cristina Bezzio,2 Michela Monteleone,2 Giulia Ramponi,1 Gian Vincenzo Zuccotti11Department of Paediatrics, 2Gastroenterology Unit, L Sacco University Hospital, Milan, ItalyBackground: The gastrointestinal tract is a primary target for human immunodeficiency virus (HIV). HIV infection causes a depletion of CD4+ T-lymphocytes in gut-associated lymphoid tissue and affects gastrointestinal mucosal integrity and permeability. The gastrointestinal tract has also been suggested as the main reservoir of HIV despite highly active antiretroviral therapy (HAART). We performed a prospective case-control study to assess gut involvement in HIV-infected patients, either naïve or on HAART, using noninvasive methods such as bowel ultrasound and fecal calprotectin.Methods: Thirty HIV-infected children and youth underwent the following tests: CD4+ T-cell count and HIV viral load, fecal calprotectin, and bowel ultrasound, with the latter evaluating bowel wall thickness and mesenteric lymph nodes. Fecal calprotectin and bowel ultrasound were also assessed in 30 healthy controls matched for age and sex. Fecal calprotectin was measured using a quantitative immunochromatographic point-of-care test, and concentrations ranging from 0 to 200 µg/g were considered to be normal reference values in children.Results: Fecal calprotectin was normal in 29 HIV-infected patients and was not significantly different from controls (mean values 63.8±42.5 µg/g and 68.3±40.5 µg/g, respectively; P=0.419), and did not correlate with HIV viral load, CD4+ T-cell absolute count and percentage, or HAART treatment. No significant changes were found on bowel ultrasound except for enlarged mesenteric lymph nodes, which were observed in seven HIV-infected patients (23.3%) and two controls (6.6%). This finding was significantly correlated with high HIV viral load (P=0.001) and low CD4+ T-cell percentage (P=0.004).Conclusion: HIV-infected children did not have significant biochemical or ultrasonographic signs of bowel inflammation. A few patients showed enlarged mesenteric lymph nodes, which correlated with uncontrolled HIV infection.Keywords: children, human immunodeficiency virus, fecal calprotectin, bowel ultrasound
format	article
author	Mantegazza C Maconi G Giacomet V Furfaro F Mameli C Bezzio C Monteleone M Ramponi G Zuccotti GV
author_facet	Mantegazza C Maconi G Giacomet V Furfaro F Mameli C Bezzio C Monteleone M Ramponi G Zuccotti GV
author_sort	Mantegazza C
title	Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus
title_short	Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus
title_full	Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus
title_fullStr	Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus
title_full_unstemmed	Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus
title_sort	gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/e84fa04363ae4f5b81dc559a4f508887
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Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus

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