[Esophageal pathology in patients with the AIDS virus. Etiology and diagnosis]

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

[Esophageal pathology in patients with the AIDS virus. Etiology and diagnosis]

Acta Gastroenterol Latinoam. 1991;21(2):67-83. Unique Identifier : AIDSLINE MED/92320852
Varsky CG; Yahni VD; Freire MC; Patrizio E; Balbo V; Benetucci J; Boffi A; Mattoni RA; Luis; Alicia M; Hospital Nacional Prof. A. Posadas, Departamento de; Gastroenterologia, Prov. de Buenos Aires, Argentina.

Abstract: From 180 patients infected with human immunodeficiency virus (HIV) and followed-up for one year, 17 cases (9.44%) were referred to detect oesophageal pathology. They were prospectively analyzed through fibroscopy, radiology, biopsies for histopathology, virology and mycology and brush cytology. Most frequent symptoms were dysphagia. Odynophagia and retrosternal pain, usually associated, and not providing an accurate diagnostic clue. The most common causes of symptoms were oesophageal candidiasis (47.70%), and herpetic ulcers (23.52%) caused by herpes simplex virus (HSV) type 2. Reflux pathology was also found (11.76%). Cytomegalovirus, other opportunistic infections and tumors were not detected. Seven (64%) of the eleven patients with oesophageal candidiasis also had oral involvement. Four (66%) of six oesophageal ulcers were herpetic; two of them (50%) showed oral ulcers too, and one (25%) had perioral herpetic blisters. Almost in every case endoscopic features allowed diagnosis. Endoscopy in candidiasis showed isolated or confluent white plaques of variable grade. Herpetic ulcers, alone or multiple, were deep with slightly elevated borders. Radiology yielded a poor diagnostic profit (50%), specially in case of multiple lesions. Cytology was highly specific and sensitive (both 90.9%) and suggested viral etiology in 100% of HSV patients. Histopathology was less sensitive than endoscopy and cytology (73% in candida and one HSV non-ulcer case). Both, cytology and histopathology showed koilocytosis in herpetic virus infected patients. The studies performed allowed to change the HIV disease stage in ten patients (62.5%) and to diagnose AIDS in seven (43.75%). In every case medical behavior was oriented or changed by these studies.

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adolescence Adult Candidiasis/*COMPLICATIONS English Abstract Esophageal Diseases/*COMPLICATIONS/DIAGNOSIS Esophagitis/COMPLICATIONS Esophagoscopy Female Herpes Simplex/COMPLICATIONS Human Male Opportunistic Infections/*COMPLICATIONS Prospective Studies Ulcer/COMPLICATIONS JOURNAL ARTICLE
921030
M92A0993

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