Diagnosis and management of esophageal disease in the acquired immunodeficiency syndrome.
BACKGROUND
Esophageal disorders are common complications of human immunodeficiency virus (HIV)-infected patients. In a significant number of patients, the esophagus may be the site of the first acquired immunodeficiency syndrome (AIDS)-defining opportunistic illness.


METHODS
We reviewed pertinent articles, obtained from a MEDLINE search, on the diagnosis and treatment of esophageal diseases in HIV disease.


RESULTS
Infections are the most common cause of esophageal disease, and opportunistic disorders such as cytomegalovirus and idiopathic esophageal ulceration rarely present until the CD4 lymphocyte count falls below 100/mm3. Endoscopy is the most valuable tool for evaluating esophageal complaints in AIDS.


CONCLUSIONS
Almost all esophageal infections in patients with AIDS are treatable; therefore, a thorough work-up is indicated. With the widespread use of more effective antiretroviral therapy including the protease inhibitors, there is a general consensus that the incidence of many opportunistic diseases appears to be decreasing.
Wilcox
C M
CM
Department of Medicine, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, 35294-0007, USA.
Mönkemüller
K E
KE
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D004359:Drug Therapy, Combination; D004935:Esophageal Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D004945:Esophagoscopy; D006801:Humans
D019380:Anti-HIV Agents; D000890:Anti-Infective Agents