Cooke M L, Goddard E A, Brown R A
School of Child and Adolescent Health, University of Cape Town, Red Cross Children's Hospital, Cape Town, South Africa.
J Trop Pediatr. 2009 Aug;55(4):238-43. doi: 10.1093/tropej/fmn114. Epub 2009 Jan 15.
The causes of persistent gastro-intestinal symptoms in HIV-infected children from sub-Saharan Africa remain poorly documented.
The clinical, radiological and endoscopic findings of all HIV-infected children who underwent upper GI endoscopy at Red Cross Children's Hospital, Cape Town, South Africa, from February 2003 to October 2005 were documented.
Twenty-six HIV-infected children underwent endoscopy; median age 1 year (range: 0.17-10.9 years). The majority had advanced HIV disease; 18 (69%) were WHO Stage 4; median CD4 10.7% (range: 1-39.8%). Presenting symptoms included persistent vomiting (18), dysphagia (4) and GIT bleed (6). Observational and histological findings showed poor correlation. Pathogens were identified in 10 children: cytomegalovirus infection in seven (two with cryptosporidium co-infection), Candida in two, Helicobacter pylori in one. Age and CD4 count were not associated with the pathogens. Endoscopy findings influenced clinical management in 21 (81%) cases.
Upper-GI endoscopy identified a diverse spectrum of disease and provided information that would be clinically relevant to most HIV-infected children with upper gastro-intestinal symptoms.
撒哈拉以南非洲地区感染艾滋病毒儿童持续出现胃肠道症状的原因，目前仍缺乏充分的文献记载。
记录了2003年2月至2005年10月期间在南非开普敦红十字会儿童医院接受上消化道内镜检查的所有感染艾滋病毒儿童的临床、放射学和内镜检查结果。
26名感染艾滋病毒的儿童接受了内镜检查；中位年龄为1岁（范围：0.17 - 10.9岁）。大多数儿童患有晚期艾滋病；18名（69%）处于世界卫生组织4期；中位CD4细胞计数为10.7%（范围：1 - 39.8%）。出现的症状包括持续呕吐（18例）、吞咽困难（4例）和胃肠道出血（6例）。观察结果与组织学结果显示相关性较差。在10名儿童中发现了病原体：7名儿童感染巨细胞病毒（其中2名同时感染隐孢子虫），2名感染念珠菌，1名感染幽门螺杆菌。年龄和CD4细胞计数与病原体无关。内镜检查结果影响了21例（81%）患者的临床治疗。
上消化道内镜检查发现了多种疾病，并提供了对大多数有上消化道症状的感染艾滋病毒儿童具有临床相关性的信息。
