HIV1 and the gut in the era of highly active antiretroviral therapy

Curr Gastroenterol Rep. 2002 Oct;4(5):392-8. doi: 10.1007/s11894-002-0009-z.


The gut and its gut-associated lymphoid tissue serve as a preferential site for HIV1 entry, active viral replication, reservoir, and HIV-mediated CD4 cell apoptosis. The widespread use of highly active antiretroviral therapy (HAART) has resulted in a significant decrease in the incidence of opportunistic enteric pathogens as a consequence of immune recovery. Nonetheless, patients with advanced HIV1 disease who were recently diagnosed or have poor response to HAART can still suffer from opportunistic infections with pathogens such as Cryptosporidium, microsporidia, Isospora belli, Cyclospora cayetanensis, Mycobacterium avium complex, and cytomegalovirus, among others. This review describes the impact of HIV1 infection on gut immune function, the salient features of the most common opportunistic enteric pathogens and HIV-associated enteropathy, and the effects of immune reconstitution after introduction of HAART.

Publication types

  • Review

MeSH terms

  • AIDS-Related Opportunistic Infections / epidemiology
  • AIDS-Related Opportunistic Infections / prevention & control*
  • Antiretroviral Therapy, Highly Active / methods*
  • Cytomegalovirus Infections / epidemiology
  • Cytomegalovirus Infections / prevention & control*
  • Female
  • HIV Enteropathy / epidemiology
  • HIV Enteropathy / prevention & control*
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV-1 / drug effects*
  • Humans
  • Incidence
  • Intestine, Small / drug effects
  • Intestine, Small / microbiology
  • Male
  • Mycobacterium Infections, Nontuberculous / epidemiology
  • Mycobacterium Infections, Nontuberculous / prevention & control*
  • Prognosis
  • Risk Assessment