The study of clinical and endoscopic spectrum of upper gastrointestinal manifestations in HIV patients

Abstract

Background: Opportunistic disorders are the most frequent GI complications of HIV infection and remain a major cause of morbidity and mortality in these patients. These disorders account for high prevalence of upper gastrointestinal symptoms such as dysphagia, odynophagia, retrosternal chest pain, abdominal pain and upper GI bleeding. Hence an attempt is being made to study clinical, endoscopic and biopsy changes in HIV patients with upper GI symptoms which helps us to make early diagnosis of upper GI disorders in HIV patients.Methods: HIV positive patients above 14 yrs diagnosed on the basis of recent NACO criteria having Upper G.I. symptoms, attending OPD of Department of Medicine admitted in Wards. All fifty three patients with upper G.I. symptoms were subjected to detail history, thorough clinical examination, routine and special investigations and Upper G.I Endoscopy.Results: Out of fifty three patients, nineteen (35.8%) cases had normal endoscopy. The most common finding was Antral Gastritis in fourteen (26.4%), followed by Candida esophagitis in twelve (22.6%), esophagitis in three (5.7%), candida esophagitis with antral gastritis in two (3.8%), duodenitis, varices and mass (ulcerated growth) in II part of Duodenum seen in one (1.9%) each.Conclusions: The evaluation of specific gastrointestinal complaints must be based on an assessment of degree of immunosuppression. With the progression of immunodeficiency, EGD becomes a useful diagnostic modality for the early diagnosis of these opportunistic infections and other inflammatory conditions.

Spectrum of Findings in Patients Presenting for Upper Gastrointestinal Endoscopy at a Tertiary Care Hospital and the Influence of Age and Gender

“…Other studies have reported diverse presenting complaints among the patients who reported for UGI endoscopy. The most common symptom encountered by Parashar and colleagues 12 , was epigastric pain seen in 49 (92.5%) patients followed by anorexia and weight loss in 45 (84.9%), and 41 (77.4%) patients respectively in an Indian hospital. Gado et al 9 , observed dyspepsia 1400 (31%), UGI bleeding 1155 (26%), and banding or sclerotherapy of varices 897 (20%) as the most frequent indications for UGI endoscopy in an Egyptian institute.…”

“…Mahmood et al 14 , reported gastritis 106 (13.85%), esophagitis 85 (11.1%), duodenal ulcer 62 (8.1%), and hiatal hernia 55 (7.2%) as the common findings. Parashar and colleagues 12 , foundantral gastritis 14 (26.4%) followed by Candidal esophagitis 12 (22.6%) as the common findings. Gado et al 9 , observed the commonest significant pathologies being pepticulcer, esophagitis, and erosive gastroduodenitis, which were diagnosed in 18%, 14%, and 8% of the patients.…”