A Review of Inflammatory Bowel Disease in Patients with Human Immunodeficiency Virus Infection

Adiga, Avinash; Panikkath, Deepa

doi:10.4172/2155-6113.1000575

Cited by 8 publications

(8 citation statements)

References 27 publications

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“…Inflammatory bowel disease (IBD) is manifested as having an aggressive immune response while HIV results in a lessened immune response in the gastrointestinal tract, leading it vulnerable to opportunistic infections (6 ). HIV infection can either improve the symptoms of an IBD patient or could cause a relapse, with the occurrence of new disease when there is a decline in CD4 count (4). A prospective study done comparing 20 IBD patients having HIV with patients who had IBD alone, found a relapse rate of 0.016 episodes per year in the HIV group compared to 0.053 in the control group (7).…”

Section: Discussionmentioning

confidence: 99%

Successful management of HIV infection in a patient with ulcerative colitis; a case report

et al. 2021

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Human immunodeficiency virus (HIV) is an infectious disease that is rarely seen in ulcerative colitis patients. Both diseases commonly involve the colon. It has been shown that treating these patients with anti-tumor necrosis factor (anti-TNF) therapy leads to remission of both conditions. We hereby present the case of a 7-year-old boy who was initially managed as a case ulcerative colitis after undergoing extensive workup and later on tested positive for HIV infection and was managed via mesalamine and highly active antiretroviral therapy (HAART). Mesalamine therapy along with HAART can be used to treat ulcerative colitis patients infected with HIV infection in resource limited countries.

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Section: Discussionmentioning

confidence: 99%

Successful management of HIV infection in a patient with ulcerative colitis; a case report

et al. 2021

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“…Within 3 weeks of acute HIV infection, more than half the CD4 T-cells in the lamina propria of the intestinal tract will have been destroyed. [4]…”

Section: Discussionmentioning

confidence: 99%

“…Accumulating evidence indicates an association between CD4 count and Ulcerative colitis (UC) flares in patients with HIV [1,2,3,4], whereby patients who have low CD4 counts are less likely to experience UC flares compared to those who have normal or elevated CD4 counts. While the exact mechanism is unknown, it is hypothesized that an immunosuppressed state allows for the remission of UC; this theory has been deemed the “Remission Hypothesis” [1].…”

Section: Introductionmentioning

confidence: 99%

CD4 Levels and Viral Load during Ulcerative Colitis Flares in Patients with Human Immunodeficiency Virus: A Case Series

Fray¹,

Likhtshteyn²,

Huynh³

et al. 2019

AJMCR

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Background:The “Remission Hypothesis” suggests that in patients with both HIV and UC an immunosuppressed state allows for the remission of UC and decreased number of flares. While the exact mechanism is unknown, this theory considers the relationship between CD4 count and flare progression. However, currently literature does not take into account the role that viral load might play in modulating flare activity.Methods:This is a case series including three patients with concurrent HIV and IBD at two large urban academic centers. A retrospective chart review was done and clinical information such as CD4+ count, viral load and flare symptoms were collected for each patient.Results:Three patients with a total of eleven UC flares were evaluated between the years of 2007 and 2018. Of the eleven flares, nine flares occurred while the viral load was undetectable, one flare occurred while the viral load was unknown, and one flare while the viral load was detectable.Conclusions:Nine out of eleven UC flares occurred while the patients’ viral loads were undetectable, which can support a “Remission Hypothesis” which is inclusive of viral load instead of CD4+ count. However, it is important to note that the disease progression of Patient 3 does not completely support this version of the hypothesis. While we cannot comment on whether the “Remission Hypothesis” is true or not, we do believe a more inclusive theory including viral load should be considered.

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“…These modifications are responsible of malabsorption, digestive discomfort, or decreased intake of nutrients. The homeostatic balance between GI bacteria and gut immunity breaks down, so commensal bacteria and their products can cross the intestinal barrier reaching the systemic circulation, bacteria in the small intestine begin to overgrow and other pathogenic bacteria may also infect the intestine [76,77,78] (Figure 2). Although ART has markedly improved survival in HIV infected individuals, microbial translocation is still not under a full control and remains associated with systemic immune activation and inflammation, characterized by elevated pro-inflammatory cytokine levels, as well as T and B cells activation.…”

Section: Bowel Condition In People Living With Hivmentioning

confidence: 99%

Microbiome and Probiotics inHealth and HIV Infection

D’Angelo¹,

Reale²,

Costantini³

2017

Preprint

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Microbiota plays a key role in various body functions, as well as in physiological, metabolic and immunological processes, through different mechanisms, such as the regulation of the development and/or functions of different types of immune cells in the intestines. Several evidences indicate that alteration in the gut microbiota can influence infectious and non-infectious diseases. Bacteria that resides on the mucosal surface or within the mucus layer interact with the host immune system, thus a healthy gut microbiota is essential for the development of mucosal immunity. The immunomodulatory activity of probiotics has been proposed in several bowel disorders or in aging-related dysfunctions. In HIV infected patients, the intestinal immune system is affected and inflammation persists during ART therapy, too. Several studies are in progress to investigate the ability of probiotics to modulate epithelial barrier functions, microbiota composition and microbial translocation in HIV infection. This mini-review aims to suggest how the use of probiotics is beneficial not only in maintaining a healthy status but also in improving HIV subjects conditions.

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A Review of Inflammatory Bowel Disease in Patients with Human Immunodeficiency Virus Infection

Cited by 8 publications

References 27 publications

Successful management of HIV infection in a patient with ulcerative colitis; a case report

Successful management of HIV infection in a patient with ulcerative colitis; a case report

CD4 Levels and Viral Load during Ulcerative Colitis Flares in Patients with Human Immunodeficiency Virus: A Case Series

Microbiome and Probiotics inHealth and HIV Infection

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