The gastrointestinal tract and HIV pathogenesis

Gastrointestinal dysfunction has been recognised as a major manifestation of the human immunodeficiency virus (HIV) infection usually presenting as diarrhoea which may or may not be due to the presence of an opportunistic infection of the GIT. Contrary to earlier assumptions, there is now substantial evidence to demonstrate that there are significant changes in the gut in the acute phase of HIV infection; the most significant of these being the substantial loss of the CD4+ T-cells in the GIT. Delays in the initiation of HAART (that is, once the CD4+ T-cell count drops below 200 cells/uL), is associated with a greater severity of HIV-associated GIT enteropathy, and poor clinical outcome