Diagnosis and Management of Esophageal Disease in the Acquired Immunodeficiency Syndrome

Cm, Wilcox; Ke, Mönkemüller

doi:10.1097/00007611-199811000-00002

Cited by 11 publications

(10 citation statements)

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“…Here, the CD4 cell count but not the viral load was significantly different between these groups. Our observations are in agreement with the well-established association of AIDS-defining events with low CD4 cell count and high viral load [5,9]. Therefore, the diagnostic yield of oesophagoscopy may be highest in patients with very advanced disease.…”

Section: Discussionsupporting

confidence: 91%

“…Endoscopic examination of both regions is essential for the diagnosis of HIVassociated diseases [1,3 Á/5]. Routine microbiological and histological analysis of specimens collected in endoscopy is standard [1,2,5]. Due to prolonged survival of patients treated with highly active antiretroviral therapy (HAART), endoscopy is a valuable tool for identifying not only opportunistic infections and malignancies, but also common disorders of chronically ill patients.…”

Section: Introductionmentioning

confidence: 99%

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Combined broncho-oesophagoscopy for diagnosis of HIV-associated disorders

Oette¹,

Trommer

Hoffmann

et al. 2005

Scandinavian Journal of Infectious Diseases

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Combined broncho-oesophagoscopy for diagnosis of HIV-associated disorders

Oette¹,

Trommer

Hoffmann

et al. 2005

Scandinavian Journal of Infectious Diseases

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“…In a review of 57 patients with AIDS and Candida esophagitis, 22 patients had coexistent cytomegalovirus (CMV) while 2 patients had Candida with CMV and herpes simplex virus (HSV). 1 Fungi other than Candida involve the esophagus rarely, and include Histoplasma capsulatum, 4 Exophiala jeanselmei, 5 and Penicillium chrysogenum. 6 The most common viral pathogen that causes esophageal disease in patients with AIDS is cytomegalovirus, seen in 10 percent to 40 7 CMV and Candida may coexist in up to 20 percent of the patients.…”

Section: Etiologymentioning

confidence: 99%

“…These disorders are not lifethreatening, therapy is usually very effective, and there is concern that widespread use of primary prophylaxis will exacerbate the problem of drug resistance. 5 Secondary prophylaxis (with fluconazole 50 to 100 mg/day or 150 mg once weekly) is commonly given for patients with multiple recurrences of oropharyngeal and/or esophageal candidiasis. For CMV disease, primary prophylaxis with oral ganciclovir has been recommended with severe immunodeficiency (CD4 cell count less than 50/mm 3 ).…”

Section: Prophylaxismentioning

confidence: 99%

Diagnosis and Management of Infectious Esophagitis Associated with Human Immunodeficiency Virus Infection

Zaidi

Cervia

2002

Journal of the International Association of Physicians in AIDS

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Esophageal disease is a common complication and cause of morbidity in patients with human immunodeficiency virus (HIV) infection. Opportunistic infections are the leading cause of esophageal complaints and may be a predictor of poor long-term prognosis, presumably as a reflection of severe underlying HIV immunodeficiency. The esophagus may be the site of the first acquired immunodeficiency syndrome (AIDS)-defining opportunistic illness in a large number of patients. Barium esophagography and upper gastrointestinal endoscopy are diagnostic modalities, commonly used to evaluate esophageal complaints in patients with AIDS. Treatment for most etiologies of esophagitis generally has a high degree of success, with a resultant improvement in quality of life. In addition to optimizing antiretroviral therapy, a thorough diagnostic assessment of every HIV-infected patient with esophageal complaints is warranted, followed by timely and appropriate treatment.

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“…Following the introduction of HAART, the incidence of esophageal OI has markedly decreased [4]. Although HAART-era routine disorders of the esophagus (such as gastroesophageal reflux disease [GERD] and pillinduced esophagitis) are increasing in incidence, OI of the esophagus may still be the presenting manifestation of HIV.…”

Section: Esophagusmentioning

confidence: 99%

Gastrointestinal manifestations of HIV infection

Wallace

Brann

2000

Curr Gastroenterol Rep

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Since the beginning of the AIDS pandemic, gastrointestinal (GI) problems have been among the most common features of the disease. Despite the introduction of highly active antiretroviral therapy (HAART) in 1995 and 1996, most HIV-infected patients continue to have GI complications. The clinician must be able to diagnose and treat the opportunistic gastrointestinal infections and neoplasms that occur in the advanced AIDS patient, as well as the treatment-induced symptoms and non-HIV-related GI disorders that predominate in early HIV disease. This review addresses the GI manifestations of HIV, with particular emphasis on new developments in the era of highly effective therapy.

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Diagnosis and Management of Esophageal Disease in the Acquired Immunodeficiency Syndrome

Cited by 11 publications

References 0 publications

Combined broncho-oesophagoscopy for diagnosis of HIV-associated disorders

Combined broncho-oesophagoscopy for diagnosis of HIV-associated disorders

Diagnosis and Management of Infectious Esophagitis Associated with Human Immunodeficiency Virus Infection

Gastrointestinal manifestations of HIV infection

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