Role of upper endoscopy in diagnosing opportunistic infections in human immunodeficiency virus-infected patients.
Highly active antiretroviral therapy (HAART) has dramatically decreased opportunistic infections (OIs) in human immunodeficiency virus (HIV)-infected patients. However, gastrointestinal disease continues to account for a high proportion of presenting symptoms in these patients. Gastrointestinal symptoms in treated patients who respond to therapy are more likely to the result of drug-induced complications than OI. Endoscopic evaluation of the gastrointestinal tract remains a cornerstone of diagnosis, especially in patients with advanced immunodeficiency, who are at risk for OI. The peripheral blood CD4 lymphocyte count helps to predict the risk of an OI, with the highest risk seen in HIV-infected patients with low CD4 count (< 200 cells/mm(3)). This review provides an update of the role of endoscopy in diagnosing OI in the upper gastrointestinal tract in HIV-infected patients in the era of HAART.
Werneck-Silva
Ana Luiza
AL
Casa da AIDS-Infectious Disease Division, School of Medicine, University of São Paulo, Rua Frei Caneca 255, CEP:05403-000, São Paulo, Brazil. alwerneck@uol.com.br
Prado
Ivete Bedin
IB
D023241:Antiretroviral Therapy, Highly Active; D001706:Biopsy; D018791:CD4 Lymphocyte Count; D002177:Candidiasis / Q000175:diagnosis / Q000453:epidemiology; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000453:epidemiology; D003680:Deglutition Disorders / Q000209:etiology / Q000382:microbiology; D004724:Endoscopy; D004935:Esophageal Diseases / Q000175:diagnosis / Q000453:epidemiology; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006561:Herpes Simplex / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000517:prevention & control; D015995:Prevalence; D013272:Stomach Diseases / Q000175:diagnosis / Q000382:microbiology