Abstract:
Gastrointestinal histoplasmosis (GIH) is infrequently described in people without underlying HIV infection. We aimed to compare the clinical presentation of GIH in people with and without HIV infection. We conducted a literature search of published cases of GIH from 2001-2021 and found 212 cases. Of these, 142 (67.0%) were male, and 124 (58.5%) had HIV infection. Most cases were from North America (n = 88, 41.5%) and South America (n = 79, 37.3%). Of the 212 cases, 123 (58.0%) were included in both clinical and pathological analyses. The remainder were excluded as details about clinical and pathological findings were not available. Of the 123 cases, 41 had HIV infection while 82 were without HIV infection. The diagnosis was predominantly by histopathology (n = 109, 88.6%). A significant proportion of people with HIV infection had abdominal pain as the most predominant symptom of GIH compared to those without HIV infection (65.9% versus 41.9%, p < 0.05). The colon was the most affected site with a slightly higher proportion in those with HIV infection compared with cases without HIV infection (46.3% versus 42.7%). The commonest pathologic findings were caecal and ileal ulcers. Caecal ulcers were significantly more frequent in cases with HIV infection compared to those without HIV (32.1% versus 7.1%, p < 0.05). Despite being more common in people with HIV infection, GIH also affects people without HIV infection with similar clinical presentations.
摘要:
胃肠道组织胞浆菌病(GIH)在没有潜在HIV感染的人群中很少被描述。我们旨在比较有和没有HIV感染的人的GIH的临床表现。我们对2001-2021年发表的GIH病例进行了文献检索,发现212例。其中,142人(67.0%)为男性,124例(58.5%)有HIV感染。大多数病例来自北美(n=88,41.5%)和南美(n=79,37.3%)。在212个案例中,123(58.0%)被纳入临床和病理分析。其余的被排除在外,因为没有关于临床和病理发现的细节。在123个案例中,41人感染了HIV,而82人没有感染HIV。诊断主要通过组织病理学(n=109,88.6%)。与未感染HIV的人相比,有很大比例的人腹痛是GIH的最主要症状(65.9%对41.9%,p<0.05)。与没有HIV感染的病例相比,结肠是受影响最严重的部位,在HIV感染的患者中比例略高(46.3%对42.7%)。最常见的病理发现是盲肠和回肠溃疡。与没有HIV感染的患者相比,在HIV感染的病例中,盲肠溃疡的发生率明显更高(32.1%对7.1%,p<0.05)。尽管在艾滋病毒感染者中更为常见,GIH也影响没有HIV感染的人,临床表现相似。