[GASTROINTESTINAL MANIFESTATIONS IN ACQUIREDIMMUNODEFICIENCE SYNDROME]
The acquired immunodeficiency syndrome (AIDS) and the humanimmunodeficiency virus infection (HIV) related opportunistic infectionscan affect the gastrointestinal tract. We review some important aspects ofesophageal and diarrheal disease in these patients. The clinicalpresentation of this complications will be related to the degree ofimmunosuppression. In developing countries esophagitis is one of the mostcommon opportunistic infections and is usually caused by Candida spp. Otherimportant causes include Cytomegalovirus, Herpes simplex and idiopathiculcers. Management in these patients is empirical, due to the high frequencyof Candida. In case there is no clinical improvement endoscopy should bedone to obtain tissue biopsies for culture and pathology. Diarrheal diseaseis also common, particularly in developing countries, where the etiologyincludes different pathogens, including Cryptosporidium, microsporidia,Cytomegalovirus and Mycobacterium avium intracellulare. Stools should be examinated for bacteria an parasites, including coccidians and microsporidia. In cases when there is a negative work up, endoscopic assessment should be done in search of a diagnosis. With the new highly active antiretroviral therapies many of these patients are having a significant clinical improvement.
Valdez Fernández Baca
Luis Manuel
LM