Feasibility and safety of research sigmoid colon biopsy in a cohort of Thai men who have sex with men with acute HIV-1

Michelle Chintanaphol, Carlo Sacdalan, Suteeraporn Pinyakorn, Rungsun Rerknimitr, Wiriyaporn Ridtitid, Piyapan Prueksapanich, Irini Sereti, Alexandra Schuetz, Trevor Acrowell, Donn J. Colby, Merlin Lrobb, Nittaya Phanuphak, Serena Sspudich, Eugène Kroon

Research output: Contribution to JournalArticleAcademicpeer-review


Background: The gut-associated lymphoid tissue (GALT) is a major reservoir of HIV-1 established early in acute HIV-1 infection (AHI). Sampling tissue from GALT can provide information about viral reservoirs and immune responses but may be complicated during AHIfor reasons such as high viral replication, CD4 T cell depletion and immune activation. Risk of adverse events (AEs) associated with research sigmoid colon biopsies was assessed in participants with AHIin Bangkok, Thailand. Methods: Between 2009 and 2016, 170 biopsies collected from the sigmoid colon were performed during AHIand at follow-up visits (median 24 weeks post AHIdiagnosis). Adverse event incidence was evaluated, as well as the associations of procedure timing, repetition and clinical parameters with AErisk. Negative binomial regression models were used to calculate incidence rate ratios and 95% confidence intervals. Results: Among 103 participants (median age of 27 years, 97.1% male, 96.1% men who have sex with men), 87 sigmoidoscopies were completed during AHIand 83 at a follow-up visit. Approximately 30 biopsies were obtained per procedure for assessment of colonic viral load and HIV-1 reservoir, immunohistochemistry or phenotypic assays. All 11 AEs were grade 1 (6.5%) and included abdominal discomfort (n = 5, 2.9%), mild rectal bleeding (n = 5, 2.9%) and difficulty passing stool (n = 1, 0.6%). Biopsy-related AErisk was not significantly associated with age, HIV-1 RNA, CD4 T cell count, or number and time of biopsy. Conclusions: Complications of sigmoidoscopy with biopsy in participants with AHIwere infrequent and mild. Longitudinal sampling of the sigmoid colon to evaluate the gut-associated HIV-1 reservoir can be safely performed as part of research studies.
Original languageEnglish
Pages (from-to)7-10
Number of pages4
JournalJournal of virus eradication
Issue number1
Publication statusPublished - 2020


  • Acute HIV-1 infection
  • Colon biopsy
  • Research risk

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