Article thumbnail

Human Immunodeficiency Virus-Associated Gastrointestinal Disease: Common Endoscopic Biopsy Diagnoses

By Feriyl Bhaijee, Charu Subramony, Shou-Jiang Tang and Dominique J. Pepper

Abstract

The gastrointestinal (GI) tract is a major site of disease in HIV infection: almost half of HIV-infected patients present with GI symptoms, and almost all patients develop GI complications. GI symptoms such as anorexia, weight loss, dysphagia, odynophagia, abdominal pain, and diarrhea are frequent and usually nonspecific among these patients. Endoscopy is the diagnostic test of choice for most HIV-associated GI diseases, as endoscopic and histopathologic evaluation can render diagnoses in patients with non-specific symptoms. In the past three decades, studies have elucidated a variety of HIV-associated inflammatory, infectious, and neoplastic GI diseases, often with specific predilection for various sites. HIV-associated esophageal disease, for example, commonly includes candidiasis, cytomegalovirus (CMV) and herpes simplex virus (HSV) infection, Kaposi's sarcoma (KS), and idiopathic ulceration. Gastric disease, though less common than esophageal disease, frequently involves CMV, Mycobacterium avium-intracellulare (MAI), and neoplasia (KS, lymphoma). Small bowel biopsies and intestinal aspirates from HIV-infected patients often show HIV enteropathy, MAI, protozoa (Giardia, Isospora, Cryptosporidia, amebae, Microsporidia), and helminths (Strongyloides stercoralis). Colorectal biopsies demonstrate viral (CMV, HSV), bacterial (Clostridia, Salmonella, Shigella, Campylobacter), fungal (cryptococcosis, histoplasmosis), and neoplastic (KS, lymphoma) processes. Herein, we review HIV-associated GI pathology, with emphasis on common endoscopic biopsy diagnoses

Topics: Review Article
Publisher: SAGE-Hindawi Access to Research
OAI identifier: oai:pubmedcentral.nih.gov:3090068
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles

Citations

  1. (2007). a r q u e s ,M .A v e r b a c h ,E .C .A .Z a n o n i
  2. (1988). Acute antibody responses to Giardia lamblia are depressed in patients with
  3. (2005). Chen,M.S.W uetal.,“Endoscopicappearance of GI mycobacteriosis caused by the Mycobacterium avium complex in a patient with AIDS: case report and review,”
  4. (1998). Cytomegalovirus colitis in acquired immunodeficiency syndrome: a clinical and endoscopic study,”
  5. (1991). Cytomegalovirus colitis in AIDS: presentation in 44 patients and a review of the literature,”
  6. (2008). e p p a ,I .P l u m b ,J .D uP a r c q ,S .T a y l o r ,a n dR .F .M i l l e r , “Gastrointestinal histoplasmosis in an HIV-infected patient living in a non-endemic area,”
  7. (1999). Enteric infections and diarrhea in human immunodeficiency virus-infected persons: prospective community-based cohort study.
  8. (1999). Epidemiology and management of diarrheal disease in HIV-infected patients,”
  9. (2004). Etiology of clinical proctitis among men who have sex with men,”
  10. (2001). Gastrointestinal histoplasmosis in patients with AIDS: case report and review,” Clinical InfectiousDiseases,vol.32,no.3,pp.483–491,
  11. (1994). Gastrointestinal histoplasmosis presenting as hematochezia in human immunodeficiency virus-infected hemophilicpatients,”American
  12. (1997). Gastrointestinal pathology in HIV-infected patients,”
  13. (2001). Gp120-induced Bob/GPR15 activation: a possible cause of human immunodeficiency virus enteropathy,”
  14. (2005). HIV infection and the gastrointestinal tract,”
  15. (2010). Infectious diseases of the intestines,” in Gastroenterological Endoscopy,M .C l a s s e n
  16. Intestinal abnormalities in AIDS,” in Gastroenterological Endoscopy,M .C l a s s e n
  17. (2001). Investigation of CMV disease
  18. (2000). K n o x ,D .S p i e g e l m a n ,S .C .S k i n n e re ta l . ,“ D i a r r h e a and abnormalities of gastrointestinal function in a cohort of men and women with HIV infection,”
  19. (2000). Lymphadenopathy and the lymphoid neoplasms associated with the acquired immune deficiency syndrome,”
  20. (2006). n t i n o r i ,C .M a g n i ,M .N e b u l o n ie ta l . ,“ H i s t o p l a s m o s i s among human immunodeficiency virus-infected people in Europe: report of 4 cases and review of the literature,”
  21. (1997). Pathophysiology of HIV-associated diarrhea,”
  22. (1992). R i c h ,J .M .C r a w f o r d ,S .N .K a z a n j i a n ,a n dP .H . Kazanjian, “Discrete gastrointestinal mass lesions caused by cytomegalovirus in patients with AIDS: report of three cases andreview,”Clinical InfectiousDiseases,vol.15,no.4,pp.609– 614,
  23. (2006). Sexually transmitted proctitis,”
  24. Spectrum of Cryptococcus neoformans infection in 68 patients infected with human immunodeficiency virus,” Reviews ofInfectiousDiseases,vol.12,no.5,pp.768–777,1990.
  25. (1995). Treatment of AIDS-associated gastrointestinal cytomegalovirus infection with foscarnet and ganciclovir: a randomized comparison,”
  26. (2010). Upper gastrointestinal endoscopic findings in the era of highly active antiretroviral therapy,”
  27. (1998). V a r s k y ,M .C .C o r r e a ,N .S a r m i e n t oe ta l . ,“ P r e v a l e n c e and etiology of gastroduodenal ulcer in HIV-positive patients: a comparative study of497symptomaticsubjects evaluated by endoscopy,”
  28. (1993). W i l c o xa n dD .A .S c h w a r t z ,“ E n d o s c o p i cc h a r a c t e r -ization of idiopathic esophageal ulceration associated with human immunodeficiency virus infection,”