Morphological changes of the small intestine mucosa in hiv/mycobacterium tuberculosis coinfection

Abstract

Introduction. To date, there are virtually no data on pathomorphological changes in the mucous membrane of the small intestine in coinfection HIV/ Mycobacterium tuberculosis (HIV/TB), which could be the basis for the development of malabsorption. The objective of the study was to investigate the pathomorphological characteristics of the small intestine mucosa in patients with coinfection HIV/TB. Materials and methods. The prospective pathomorphological study included 24 patients with HIV/TB coinfection (main group), and 20 patients without HIV infection, gastrointestinal pathology or morphological signs of TB (control group). Results. The thickness of the small intestine mucosa, the average height and width of villi were significantly lower in the HIV/TB group compared with the control group (p<0.05). The relative area of connective tissue in the small intestine mucosa was increased in the main group (p<0.05). The coefficient of variation of the optical density of nuclear chromatin in the main group noticeably exceeded the coefficient in the control group: 42.7±6.47% vs. 6.7±0.34% (p<0.05). The red/blue (R/B) ratio in the main group almost doubled that of the control group, while the quantitative index of the optical density of the specific colour for free amino groups was 1.7 times higher than in the control group (p<0.05). Conclusions. Coinfection HIV/TB is accompanied by the development of atrophic and sclerotic changes in the small intestine, a decrease in the functional activity of enterocytes and increased intensity of free radical processes.