HIV infection is reportedly associated with an increased permeability of the intestinal epithelium and can cause HIV enteropathy,\nwhich occurs independently of opportunistic infections. However, the characteristics of small bowel abnormalities attributable\nto HIV infection are rarely investigated. In the present study, we assessed the intestinal mucosal changes found in HIVinfected\npatients and compared them with the mucosa of healthy control subjects using capsule endoscopy (CE). Three of\nthe 27 HIV-infected patients harbored gastrointestinal opportunistic infections and were thus excluded from subsequent\nanalyses. The endoscopic findings of CE in HIV-infected patients were significantly higher than those in control subjects\n(55% versus 10%, P = 0 002); however, most lesions, such as red spots or tiny erosions, were unlikely to cause abdominal\nsymptoms. After validating the efficacy of CE for the diagnosis of villous atrophy, we found that the prevalence of villous\natrophy was 54% (13/24) among HIV-infected patients. Interestingly, villous atrophy persisted in patients receiving long-term\nantiretroviral therapy, though most of them exhibited reconstituted peripheral blood CD4+ T cells. Although we could not draw\nany conclusions regarding the development of small bowel abnormalities in HIV-infected patients, our results may provide\nsome insight regarding the pathogenesis of HIV enteropathy.
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