Contemporary Insights Into HIV Esophagitis: Pathogenesis, Therapeutic Strategies, and Prognostic Outcomes

• Published in: Curēus (Palo Alto, CA) CA), 2024-05, Vol.16 (5), p.e60788
• Main Authors: Sharma, Dhruvikumari D, Girgis, Peter, Gandhi, Dhruv, Adapa, Sparshitha, Karishma, Fnu, Kaur, Gurvir, Balasingh, Gohul P, Ismail Elnimer, Mostafa Mohamed
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Bacterial infections; Gastroenterology; HIV; HIV/AIDS; Human immunodeficiency virus; Infectious Disease; Medical prognosis; Protozoa
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.60788

Opportunistic infections caused by various bacteria, viruses, fungi, or parasites can cause esophagitis. The fungus is often believed to be the thief behind this disorder. This condition's distinctive signs include the process of inflammation and the development of esophageal ulcers. The underlying immunodeficiency condition in HIV/AIDS patients, especially those in the late stages of the disease, may lead to severe illness or even death if the lowered immune system can no longer combat common infections. These individuals are, therefore, more at risk of contracting diseases like Candidiasis since they already have weakened immune systems. Furthermore, bacteria and mycobacteria can cause esophagitis in the same way that viruses can. Tobacco use, alcohol drinking, and nutritional deficiency are three additional problems that can lead to an HIV esophagitis infection. Complaints of inability to swallow, suffocating feeling or discomfort behind the breastbone, and painful swallowing are the primary symptoms of the patients. White plaques or ulcers observed in the esophagus during an endoscopy can be biopsied for further examination. The presence of hyphae and inflammatory infiltrates in these samples confirms the diagnosis of HIV-associated esophagitis. Treatment involves the use of antifungal medications and addressing any underlying causes of esophagitis, which is linked to AIDS. For superficial to moderate infections, fluconazole is typically used first. If the disease is severe or recurs after treatment, intravenous amphotericin B may be necessary. Patients with recurring oral symptoms of HIV esophagitis might also need to take antifungal drugs as a preventative measure.