Isolation of mycobacteria from stools and intestinal biopsies from HIV seropositive and HIV seronegative patients with and without diarrhea in Kinshasa, Zaïre; preliminary results

To determine the role of mycobacteria as etiologic agent in HIV related enteritis in Africa, the following study was performed in 1986, in the department of Internal Medicine in Mama Yemo Hospital in Kinshasa, Zaire. Stool and intestinal biopsies were obtained from HIV seropositive and HIV seronegative patients with and without diarrhea. Patients with known Mycobacterium tuberculosis infection were not enrolled. Acid fast bacilli were found in fecal smears of 6 (10%) of 59 HIV seropositive patients and in none of 41 HIV seronegative patients (p = 0.04). Isolation rates of mycobacteria were slightly lower in HIV seropositive patients than in HIV seronegative patients (25% vs 44%, p = 0.08) and significantly lower in patients with diarrhea than in patients without diarrhea (15% vs 44%, p = 0.02). Mycobacterium avium-intracellulare was the species most frequently isolated from stools, in 12% of the HIV seropositive and in 22% of the HIV seronegative patients. Mycobacteria were not isolated from any of the intestinal biopsies obtained in 17 HIV seropositive patients with persistent diarrhea and any of these biopsies showed histological evidence of a mycobacterial infection. This study suggests that mycobacteria do not seem to play a major role in causing diarrhea in HIV seropositive patients