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PLoS One. 2017 Sep 8;12(9):e0184272. doi: 10.1371/journal.pone.0184272. eCollection 2017.

High prevalence of gastric intestinal metaplasia detected by confocal laser endomicroscopy in Zambian adults.

Author information

1
Tropical Gastroenterology & Nutrition group, Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
2
Cancer Diseases Hospital, Pathology section, Lusaka, Zambia.
3
Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
4
Blizard Institute, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

Abstract

BACKGROUND:

Confocal laser endomicroscopy (CLE) may increase the detection of gastric premalignant lesions, and facilitate targeted biopsies for histology. The study aim was to analyse premalignant lesions in Zambian adults using CLE.

METHODS:

Using CLE and histology we analysed the antral mucosa for gastric premalignant lesions in asymptomatic adults living with HIV and in HIV seronegative adults. Fasting gastric pH and the presence of Helicobacter pylori (H. pylori) were also evaluated.

RESULTS:

We enrolled 84 HIV seropositive participants (median age 43 years; 55 (65%) female), of whom 32 (38%) were anti-retroviral therapy (ART)-naïve. Also enrolled were 22 HIV seronegative controls (median age 39 years, 12 (55%) females). Hypochlorhydria was found in 48 (57%) HIV positive and 8 (38%) HIV negative controls (P = 0.14). Detection of gastric intestinal metaplasia (GIM) was higher (P = 0.007) using CLE (49, 54%) than histology (9, 9%) and, using CLE, GIM was similar between HIV positive (41, 60%) and negative groups (8, 36%; P = 0.08). Gastric luminal fluorescein leakage was significantly associated with the presence of GIM [OR 8.2; 95% CI 2.5-31, P<0.001].

CONCLUSION:

CLE is useful for the detection of GIM, and luminal fluorescein leakage may represent a novel CLE marker for GIM. GIM is common in Zambian adults, and is highly prevalent irrespective of HIV infection or use of ART.

PMID:
28886101
PMCID:
PMC5590914
DOI:
10.1371/journal.pone.0184272
[Indexed for MEDLINE]
Free PMC Article

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