Document 2639
 DOCN  M94A2639
 TI    Enteric pathogens in postmortem tissue of pediatric HIV patients.
 DT    9412
 AU    Ramos AG; Wu TC; Saavedra JM; Bobo LD; Livingston RA; Perman JA; Yolken
       RH; Dept. of Pediatrics, Johns Hopkins Hospital, Baltimore, MD.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):259 (abstract no. PB0464). Unique
       Identifier : AIDSLINE ICA10/94369936
 AB    There is limited data on the cause of failure to thrive (FTT) and
       chronic diarrhea in pediatric HIV. Previous studies on stool have failed
       to demonstrate a significant pathogen in children. Autopsy studies may
       provide the links to the etiology of gastrointestinal (GI) dysfunction.
       OBJECTIVE: We undertook the present study to search for enteric
       pathogens, specifically cytomegalovirus (CMV) and Herpes simplex virus 1
       & 2 (HSV), in postmortem GI tissue of pediatric HIV patients who had FTT
       or chronic diarrhea in whom microbiologic tests on stool failed to
       identify a pathogen. METHODS: The immunohistochemical (IHC) technique
       was employed in all samples while in situ hybridization was done in
       selected cases. RESULTS: All 8 pediatric HIV patients who died at our
       institution from 1986 to 1993 had GI-related symptoms prior to death.
       Ages ranged from 4 1/2 mos. to 14 yrs. Enteropathogens were detected in
       4/8 (50%); 2 with CMV, 1 with HSV, 1 with both CMV and HSV. All of them
       had no focus of systemic infection with these pathogens. DISCUSSION AND
       CONCLUSIONS: Our findings suggest that the Herpesvirus family can be
       found in postmortem GI tissue of pediatric HIV patients who had chronic
       diarrhea and FTT using IHC when routine methods fail to detect any
       pathogen in stool. This virus may be a significant etiologic agent of GI
       dysfunction in pediatric HIV. These may be the basis of future
       controlled studies on the role of enteropathogens in the enteropathy of
       HIV disease.
 DE    Adolescence  AIDS-Related Opportunistic Infections/*PATHOLOGY  Child
       Child, Preschool  Cytomegalovirus Infections/PATHOLOGY  Diarrhea,
       Infantile/*PATHOLOGY  Failure to Thrive/*PATHOLOGY
       Gastroenteritis/*PATHOLOGY  Gastrointestinal System/PATHOLOGY  Herpes
       Simplex/PATHOLOGY  Human  Infant  MEETING ABSTRACT

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