[Endoscopic approach in HIV infected-patients with upper gastrointestinal symptoms].
Upper gastrointestinal symptoms such as nausea, vomiting, upper abdominal pain, heartburn, early satiety, bloating and anorexia, are frequently reported by HIV positive patients; however, their prevalence and diagnostic approach are unknown.


OBJECTIVE
To evaluate the frequency of endoscopic and histologic diagnosis in HIV positive patients with upper gastrointestinal symptoms referred to upper endoscopy, and to compare them with those found in a non-HIV infected group with similar symptoms.


METHODS
Out of 132 HIV positive patients referred to upper endoscopy, 102 (75%) with upper gastrointestinal symptoms, and 177 non-HIV controls were prospectively included. All patients answered questionnaires assessing frequency, severity and impact of symptoms on quality of life, and underwent upper endoscopy with systematic mucosal biopsies from esophagus, stomach and distal duodenum.


RESULTS
Upper abdominal pain, heartburn and bloating were the most common upper gastrointestinal symptom reported in both groups. Anorexia, nausea, vomiting and early satiety were more frequent among HIV positive patients (p = or < 0.01). Intensity and impact of symptoms quality of life were higher in this group (p = 0.0001). Opportunistic infections were detected in 29 (28.4%) HIV positive patients. This subgroup had a lower mean CD4 count (p = 0.0004). In 76 (75.4%) HIV positive non-opportunistic diseases were diagnosed, with similar frequency to HIV negative individuals.


CONCLUSIONS
Upper endoscopy with biopsies detected opportunistic and non-opportunistic diseases in HIV positive patients with upper gastrointestinal symptoms. Opportunistic diseases were related to lower CD4 counts. Non-opportunistic diseases had similar frequency in both groups, HIV positive and negative controls.
Olmos
Martín Alejandro
MA
División de Gastroenterología, Hospital Fernández, Buenos Aires, Argentina. molmos@fibertel.com.ar
Fanín
Ana
A
Araya
Valentina
V
Piskorz
Eduardo
E
Quesada
Eduardo Coronado
EC
Magnanini
Fernando
F
Concetti
Hugo
H
Perez
Héctor
H
Cahn
Pedro
P
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000453:epidemiology; D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D001118:Argentina / Q000453:epidemiology; D001706:Biopsy; D018791:CD4 Lymphocyte Count; D016145:Endoscopy, Digestive System; D004812:Epidemiologic Methods; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications*; D016481:Helicobacter Infections / Q000150:complications; D006801:Humans; D008297:Male