Combined broncho-oesophagoscopy for diagnosis of HIV-associated disorders.
The aim of the study was to characterize the value of combined endoscopy of tracheobronchial tree and oesophagus within 1 session for diagnosis of HIV-associated disorders. Hospitalized HIV-positive patients who underwent combined flexible broncho-oesophagoscopies between 1999 and 2002 in 2 units for infectious diseases were studied retrospectively. 54 HIV patients were analysed; 89% were at stage CDC C, 79% were male, mean age was 40 y. Bronchoscopy led to a diagnosis in 57.4% (95% CI 43.2-70.8). In 40.7%, these were AIDS-defining events (ADE) and 16.7% were general disorders (GD). Oesophagoscopy was diagnostic in 46.3% (95% CI 32.6-60.4). In 35.2% these were ADE, and 11.1% were GD. Patients with pathological oesophagoscopy had a significantly lower CD4 cell count and a higher viral load. There was no association of pathological bronchoscopy with pathological oesophagoscopy regarding ADE. No severe complication was recorded. It is concluded that combined flexible broncho-oesophagoscopy is a valuable and safe method for the diagnosis of HIV-associated disorders. The diagnostic output is highest in patients with advanced disease. A pathological finding in oesophagoscopy cannot be predicted by the presence of bronchoscopic abnormalities. Prospective studies are necessary to confirm these results.
Oette
Mark
M
Clinics for Gastroenterology, Hepatology, and Infectious Diseases, Düsseldorf, Germany. oettem@med.uni-duesseldorf.de
Trommer
Ingo
I
Hoffmann
Rudolf
R
Schwalen
Andreas
A
Mitrenga
Dieter
D
Thoma
Rudolf
R
Wettstein
Matthias
M
Häussinger
Dieter
D
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis*; D000328:Adult; D001999:Bronchoscopy / Q000379:methods*; D003141:Communicable Diseases / Q000175:diagnosis*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D008297:Male; D012189:Retrospective Studies