Ultrastructural changes in the duodenal mucosa of HIV-infected children.

: We studied the ultrastructure of duodenal biopsy specimens from six HIV-infected children with chronic gastrointestinal symptoms. A monomorphic pattern of microvillar damage (short and irregular microvilli, joined at their bases) was seen in all cases, even when the mucosa was normal on conventional histology. Among nine HIV antibody negative children, a similar pattern was seen only in three out of four celiac children with severely atrophic mucosa. No viral, bacterial, or protozoan pathogen was found. In HIV-infected children tubuloreticular inclusions were also seen in endothelial cells. These ultrastructural changes could help to account for the gastrointestinal symptoms in HIV-infected children.