HIV/SIV enteropathy

Ann N Y Acad Sci. 1998 Nov 17;859:139-48. doi: 10.1111/j.1749-6632.1998.tb11118.x.


Evidence is increasing that HIV/SIV-induced changes in the highly differentiated gut-associated immune system play a central role in the pathogenesis of gastrointestinal manifestations in HIV/SIV infection. It has been shown in both humans infected with HIV and in nonhuman primates infected with SIV that a rapid, very early, and more pronounced loss of CD4+ T-cells occurs in the mucosa in comparison to the peripheral blood. The loss of this important regulatory T-cell subset might explain mucosal immunodeficiency with the consequence of opportunistic mucosal infections. In addition, there is evidence that small intestinal damage occurs independently of secondary infections (HIV/SIV enteropathy). In late-stage human disease, HIV enteropathy is characterized by villous atrophy with hyporegeneration and dysmaturation of intestinal epithelial cells. In SIV infection of macaques, villous atrophy is a very early event; however, it is accompanied by crypt cell hyperproliferation. Early- and late-stage enteropathy in immunodeficiency virus infection may represent two types of immunologically mediated mucosal transformation in which the number and state of activation of regulatory T cells determine whether hypo- or hyperproliferative villous atrophy occurs.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications
  • Acquired Immunodeficiency Syndrome / immunology
  • Acquired Immunodeficiency Syndrome / physiopathology*
  • Animals
  • HIV Infections / complications
  • HIV Infections / immunology
  • HIV Infections / physiopathology*
  • HIV*
  • Humans
  • Immunity, Mucosal
  • Intestinal Diseases / etiology*
  • Intestinal Diseases / immunology
  • Intestinal Diseases / physiopathology
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / pathology
  • Intestinal Mucosa / physiopathology
  • Intestine, Small / pathology
  • Intestine, Small / physiopathology
  • Primates
  • Simian Acquired Immunodeficiency Syndrome / complications
  • Simian Acquired Immunodeficiency Syndrome / immunology
  • Simian Acquired Immunodeficiency Syndrome / physiopathology*
  • Simian Immunodeficiency Virus*
  • T-Lymphocyte Subsets / immunology