The Influence of Age, Smoking, Antiretroviral Therapy, and Esophagitis on the Local Immunity of the Esophagus in Patients with AIDS

Abstract

Studies have shown immunological and morphological alterations in the esophagus during the course of AIDS. Esophageal postmortem samples of 22 men with AIDS autopsied in a teaching hospital between 1982 and 2009 were collected. We carried out revision of the autopsy reports and medical records, morphometric analysis (Image J and KS-300 Kontron-Zeiss), and immunohistochemical (anti-S100, anti-IgA, anti-IgG, and anti-IgM) analysis of the esophagus. In accordance with most of the parameters evaluated, age and the smoking habit harmed the esophageal local immunity, whereas the use of antiretroviral therapy improved the immune characteristics of this organ. Patients with esophagitis also presented immunological fragility of the esophagus. This leads to the conclusion that alterations in the esophageal epithelium of patients with AIDS are not only caused by direct action of HIV but also the clinical and behavioral characteristics of the patient.

Smoking and HIV-related Health Issues among Older HIV-positive Gay, Bisexual, and Other Men Who Have Sex with Men

“…4 One common coping mechanism is cigarette smoking. 5 Although some studies have highlighted beneficial side effects of cigarette smoking, including its role as an anti-inflammatory agent and the neuroprotective qualities it may provide, the majority of the literature has focused on the myriad deleterious smoking-related health outcomes, 6;7 including pneumonia and other respiratory infections, 8–10 gastrointestinal problems, 11–13 cardiovascular disease (CVD), increased morbidity and mortality, 14;15 mortality from non-AIDS malignancies, 14 a higher viral load, 16 the decreased effectiveness of HIV antiviral therapies, 17 and a faster progression to AIDS. 17;18 …”