Role of upper endoscopy in diagnosing opportunistic infections in human immunodeficiency virus-infected patients

• Published in: World journal of gastroenterology : WJG 2009-03, Vol.15 (9), p.1050-1056
• Main Authors: Werneck-Silva, Ana Luiza, Prado, Ivete Bedin
• Format: Article
• Language: English
• Subjects: Antiretroviral Therapy, Highly Active; Biopsy; Candidiasis - diagnosis; Candidiasis - epidemiology; CD4 Lymphocyte Count; CD4淋巴细胞计数; CD4细胞计数; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - epidemiology; Deglutition Disorders - etiology; Deglutition Disorders - microbiology; Endoscopy; Esophageal Diseases - diagnosis; Esophageal Diseases - epidemiology; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - immunology; Gastrointestinal Diseases - microbiology; Herpes Simplex - diagnosis; Herpes Simplex - pathology; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - immunology; Humans; Opportunistic Infections - diagnosis; Opportunistic Infections - prevention & control; Prevalence; Stomach Diseases - diagnosis; Stomach Diseases - microbiology; Topic Highlight; 人类免疫缺陷病毒; 内镜诊断; 抗逆转录病毒疗法; 机会性感染; 艾滋病毒感染者; 鸡尾酒疗法
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.15.1050

Highly active antiretroviral therapy （HAART） has dramatically decreased opportunistic infections （OIs） in human immunodeficiency virus （HIV）-infected patients. However, gastrointestinal disease continues to account for a high proportion of presenting symptoms in these patients. Gastrointestinal symptoms in treated patients who respond to therapy are more likely to the result of drug-induced complications than OI. Endoscopic evaluation of the gastrointestinal tract remains a cornerstone of diagnosis, especially in patients with advanced immunodeficiency, who are at risk for OI. The peripheral blood CD4 lymphocyte count helps to predict the risk of an OI, with the highest risk seen in HIV-infected patients with low CD4 count （〈 200 cells/mm^3）. This review provides an update of the role of endoscopy in diagnosing OI in the upper gastrointestinal tract in HIV-infected patients in the era of HAART.