Corti M, Villafañe M F
Hospital de Infecciosas F. J. Muñiz Ciudad de Buenos Aires, Argentina.
Acta Gastroenterol Latinoam. 2003;33(4):211-20.
Esophageal disease is a common complication in patients infected with human immunodeficiency virus type-1 (HIV-1). Dysphagia, odynophagia and retrosternal pain are the most common symptons associated with the esophageal compromise. Esophageal candidiasis, the most frequent opportunistic infection, may occur in patients with long-standing infection or may be a manifestation of the seroconversion. Cytomegalovirus and Herpes simplex virus are more likely to produce esophageal ulcers or erosions. HIV itself may be responsible for ulcerative esophagitis. Neoplasms as Kaposi's sarcoma, are an infrequent cause of symptomatic disease. Barium esophagography and specially upper endoscopy are the most commonly employed diagnostic modalities for the evaluation of symptomatic patients. Endoscopy may be warranted to make a rapid diagnosis such that specific therapy will not be delayed. The use of a combination of histologic, cytologic, mycologic and virologic studies is necessary to provide an etiologic diagnosis of these lesions.
食管疾病是感染1型人类免疫缺陷病毒(HIV-1)患者的常见并发症。吞咽困难、吞咽痛和胸骨后疼痛是与食管损害相关的最常见症状。食管念珠菌病是最常见的机会性感染,可能发生在长期感染的患者中,也可能是血清转化的一种表现。巨细胞病毒和单纯疱疹病毒更易导致食管溃疡或糜烂。HIV本身可能是溃疡性食管炎的病因。肿瘤如卡波西肉瘤是症状性疾病的罕见病因。食管钡餐造影,特别是上消化道内镜检查是评估有症状患者最常用的诊断方法。可能需要进行内镜检查以快速诊断,从而不延误特异性治疗。需要结合组织学、细胞学、真菌学和病毒学研究来对这些病变进行病因诊断。