Diagnostic esophago-gastro-duodenoscopy (EGD) in patients with AIDS-related upper gastrointestinal abnormalities.
OBJECTIVE
Gastrointestinal (GI) diseases are common among patients infected with human immunodeficiency virus (HIV), and may involve the entire GI tract. The aim of the article is to investigate the prevalence of various upper gastrointestinal abnormalities in patients with AIDS.


METHODS
Diagnostic esophago-gastro-duodenoscopy (EGD) was performed in cohort of AIDS patients (total 186) including non-ART, mono and/or dual ART and HAART treated subgroups. Clinical presentation, level of immunosupression and presence of H. pylori infection was also considered.


RESULTS
Endoscopic findings included normal (29), esophageal candidiasis (22), esophageal erosions (16), gastritis/duodenitis (135), gastric/duodenal ulcers (7), erosions (6) and infiltration/tumor in the stomach (5). Thirty-nine patients (20.4%) had opportunistic infections/tumors including candida esophagitis, CMV esophagitis, CMV gastritis, gastric non-Hodgkin's lymphoma (NHL) and gastric cryptosporidiosis. H. pylori infection was present in 25.8% of patients, and majority (89.6%) had chronic non-atrophic gastritis. These patients had a higher mean CD4 count compared with H. pylori negative patients (403.5 vs. 226.9 CD4+ cells/microL, p = 0.001). Patients who received HAART had significantly higher frequency of H. pylori infection then non-ART treated patients (p = 0.048).


CONCLUSIONS
Candidiasis was the marker of advanced immunodeficiency, and H. pylori was more common in patients with higher CD4 cell counts on ART, which may suggest that this infection could be an unusual presentation of immune restoration inflammatory syndrome.
Korać
Milos
M
Institute for Infectious & Tropical Diseases, University of Belgrade School of Medicine, Belgrade, Serbia.
Brmbolić
Branko
B
Salemović
Dubravka
D
Ranin
Jovan
J
Stojsić
Zorica
Z
Jevtović
Djordje
D
Nikolić
Jelena
J
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000293:Adolescent; D000328:Adult; D000368:Aged; D004384:Duodenoscopy; D004945:Esophagoscopy; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000382:microbiology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies