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HIV related hypochlorhydria does not appear to respond to anti-retroviral therapy in Zambian adults: a case control study.
Pan Afr Med J 2018; 31:128PA

Abstract

Introduction

Human Immunodeficiency Virus (HIV) infection is associated with hypochlorhydria but the mechanism is unknown. The objective of this study was to determine effects of anti-retroviral therapy (ART) on gastric physiology as measured by validated markers.

Methods

We studied HIV infected individuals who were either ART-naïve or on treatment with undetectable viral loads. We measured H.pylori IgG antibodies, pepsinogen (PG) 1 and 2 levels and fasting gastrin-17 using Biohit GastroPanel®. Gastric antral biopsies and juice were obtained for histology and pH respectively. Also included were historical data from HIV negative participants (n = 72) in a previous study, for reference.

Results

We enrolled 84 HIV positive individuals with a median age 42 years (IQR 37-40 years). 55(66%) were female, 32(38%) were ART naïve, and 52(62%) were on ART. Hypochlorhydria (pH>4) was present in 48(57%) of the HIV positive and 18(25%) of the HIV negative individuals (OR 4: 95% CI 1.9-8.5, P<0.001) with no significant effect of ART (OR 0.9: 95% CI 0.3-2.3, P = 0.82). Hypochlorhydria was not associated with the serological detection of corpus atrophy using low PG 1:2 ratio (OR 2.1: 95% CI 0.5-10.2, P = 0.37) or GastroPanel® algorithm, (OR 0.7: 95% CI 0.01-60.1, P = 1.0). ART reduced the frequency of low PG 1:2 ratio (P = 0.001), but not the histological detection in the antrum of atrophy or non-atrophic gastritis.

Conclusion

ART use is associated with reduced serological evidence of corpus atrophy but has no effect on fasting pH, supporting earlier data that suggest that the mechanism of HIV-associated hypochlorhydria is multifactorial.

Authors+Show Affiliations

Tropical Gastroenterology & Nutrition Group, Department of Internal Medicine, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia.Cancer Diseases Hospital, Pathology section, Nationalist Road, Lusaka, Zambia.Tropical Gastroenterology & Nutrition Group, Department of Internal Medicine, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia.Vanderbilt Institute of Global Health, Vanderbilt Medical Center, 2525 West End Avenue, Suite 750, Nashville, 37203, Tennessee, USA.Vanderbilt Institute of Global Health, Vanderbilt Medical Center, 2525 West End Avenue, Suite 750, Nashville, 37203, Tennessee, USA.Tropical Gastroenterology & Nutrition Group, Department of Internal Medicine, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia. Blizard Institute, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London E1 2AT, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31037188

Citation

Kayamba, Violet, et al. "HIV Related Hypochlorhydria Does Not Appear to Respond to Anti-retroviral Therapy in Zambian Adults: a Case Control Study." The Pan African Medical Journal, vol. 31, 2018, p. 128.
Kayamba V, Shibemba A, Zyambo K, et al. HIV related hypochlorhydria does not appear to respond to anti-retroviral therapy in Zambian adults: a case control study. Pan Afr Med J. 2018;31:128.
Kayamba, V., Shibemba, A., Zyambo, K., Heimburger, D. C., Morgan, D., & Kelly, P. (2018). HIV related hypochlorhydria does not appear to respond to anti-retroviral therapy in Zambian adults: a case control study. The Pan African Medical Journal, 31, p. 128. doi:10.11604/pamj.2018.31.128.11850.
Kayamba V, et al. HIV Related Hypochlorhydria Does Not Appear to Respond to Anti-retroviral Therapy in Zambian Adults: a Case Control Study. Pan Afr Med J. 2018;31:128. PubMed PMID: 31037188.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HIV related hypochlorhydria does not appear to respond to anti-retroviral therapy in Zambian adults: a case control study. AU - Kayamba,Violet, AU - Shibemba,Aaron, AU - Zyambo,Kanekwa, AU - Heimburger,Douglas Corbett, AU - Morgan,Douglas, AU - Kelly,Paul, Y1 - 2018/10/22/ PY - 2017/01/30/received PY - 2018/06/16/accepted PY - 2019/5/1/entrez PY - 2019/5/1/pubmed PY - 2019/5/16/medline KW - HIV KW - gastric atrophy KW - hypochlorhydria KW - intestinal metaplasia KW - pepsinogen SP - 128 EP - 128 JF - The Pan African medical journal JO - Pan Afr Med J VL - 31 N2 - Introduction: Human Immunodeficiency Virus (HIV) infection is associated with hypochlorhydria but the mechanism is unknown. The objective of this study was to determine effects of anti-retroviral therapy (ART) on gastric physiology as measured by validated markers. Methods: We studied HIV infected individuals who were either ART-naïve or on treatment with undetectable viral loads. We measured H.pylori IgG antibodies, pepsinogen (PG) 1 and 2 levels and fasting gastrin-17 using Biohit GastroPanel®. Gastric antral biopsies and juice were obtained for histology and pH respectively. Also included were historical data from HIV negative participants (n = 72) in a previous study, for reference. Results: We enrolled 84 HIV positive individuals with a median age 42 years (IQR 37-40 years). 55(66%) were female, 32(38%) were ART naïve, and 52(62%) were on ART. Hypochlorhydria (pH>4) was present in 48(57%) of the HIV positive and 18(25%) of the HIV negative individuals (OR 4: 95% CI 1.9-8.5, P<0.001) with no significant effect of ART (OR 0.9: 95% CI 0.3-2.3, P = 0.82). Hypochlorhydria was not associated with the serological detection of corpus atrophy using low PG 1:2 ratio (OR 2.1: 95% CI 0.5-10.2, P = 0.37) or GastroPanel® algorithm, (OR 0.7: 95% CI 0.01-60.1, P = 1.0). ART reduced the frequency of low PG 1:2 ratio (P = 0.001), but not the histological detection in the antrum of atrophy or non-atrophic gastritis. Conclusion: ART use is associated with reduced serological evidence of corpus atrophy but has no effect on fasting pH, supporting earlier data that suggest that the mechanism of HIV-associated hypochlorhydria is multifactorial. SN - 1937-8688 UR - https://www.unboundmedicine.com/medline/citation/31037188/HIV_related_hypochlorhydria_does_not_appear_to_respond_to_anti-retroviral_therapy_in_Zambian_adults:_a_case_control_study L2 - http://www.panafrican-med-journal.com/content/article/31/128/full/ DB - PRIME DP - Unbound Medicine ER -