Frisancho Velarde O
Servicio de Gastroenterología, Hospital Nacional Edgardo Rebagliati Martins, IPSS, Lima, Perú.
Rev Gastroenterol Peru. 1991;11(2):86-96.
The gastrointestinal system is a target organ for many infection in the immunosuppressed. Alterations in mucosal immunity may explain the increased incidence of enteric infections, abnormalities are most marked by a decrease in total T cells, CD4 T cells and IgA producing cells. Such involvement of the gastrointestinal tract contributes to nutritional problems and may provide a portal entry for systemic infection. Gastrointestinal manifestation of patients with AIDS has been found in 78% of patients in Perú; chronic debilitating diarrhea is commonly. These immune deficits predispone such patients to rare tumors; malignant neoplasia complicate AIDS in 12% of the cases in USA, most common was Kaposi sarcoma followed by Lymphoma. Liver abnormalities are common, those related to the opportunistic infections, chronic debilitating illness and concident exposure to hepatotropic viruses. Disinfection of the endoscopic instruments is very important; glutaraldehydes can be used in fiberoptic instruments and their accessories. This report reviews the clinical problems, diagnosis and treatment in patients with AIDS and gastrointestinal manifestation.
胃肠道系统是免疫抑制患者许多感染的靶器官。黏膜免疫的改变可能解释肠道感染发病率的增加,异常最明显的表现为总T细胞、CD4 T细胞和产生IgA的细胞减少。胃肠道的这种受累会导致营养问题,并可能为全身感染提供门户入口。在秘鲁,78%的艾滋病患者出现了胃肠道表现;慢性衰弱性腹泻很常见。这些免疫缺陷使此类患者易患罕见肿瘤;在美国,12%的艾滋病病例并发恶性肿瘤,最常见的是卡波西肉瘤,其次是淋巴瘤。肝脏异常很常见,与机会性感染、慢性衰弱性疾病以及同时接触嗜肝病毒有关。内镜器械的消毒非常重要;戊二醛可用于纤维光学器械及其附件。本报告回顾了艾滋病患者胃肠道表现的临床问题、诊断和治疗。