Hirschel B
Département de médecine interne, Hôpital cantonal universitaire, Genève.
Schweiz Med Wochenschr. 1990 Apr 7;120(14):475-84.
The majority of patients with Aids suffer from diarrhea and weight loss, as well as opportunistic infection and tumors of the gastrointestinal tract; endoscopy is frequently necessary. Often, but not always, it is possible to identify an opportunistic tumor or infection which explains the patient's signs and symptoms. In other cases, HIV may itself be pathogenic. The most important opportunistic pathogens are Candida albicans (stomatitis and esophagitis), cytomegalovirus and herpes simplex virus (esophagus, stomach, biliary system, colon), cryptosporidium (small intestine, biliary system), Isospora belli (small intestine), salmonella, shigella, and campylobacter (small and large intestine, septicemia), and Mycobacterium avium intracellulare (liver, spleen, intestinal submucosa, and bacteremia). Involvement of the gastrointestinal tract is frequent in Kaposi's sarcoma, though it is often asymptomatic. In contrast, gastrointestinal lymphomas are aggressive and rapidly progressive tumors.
大多数艾滋病患者会出现腹泻、体重减轻,以及胃肠道的机会性感染和肿瘤;内镜检查常常是必要的。通常,但并非总是如此,有可能识别出一种机会性肿瘤或感染,它可以解释患者的体征和症状。在其他情况下,艾滋病毒本身可能具有致病性。最重要的机会性病原体有白色念珠菌(口腔炎和食管炎)、巨细胞病毒和单纯疱疹病毒(食管、胃、胆道系统、结肠)、隐孢子虫(小肠、胆道系统)、贝氏等孢球虫(小肠)、沙门氏菌、志贺氏菌和弯曲杆菌(小肠和大肠、败血症),以及鸟分枝杆菌胞内菌(肝脏、脾脏、肠黏膜下层和菌血症)。胃肠道受累在卡波西肉瘤中很常见,尽管通常无症状。相比之下,胃肠道淋巴瘤是侵袭性且进展迅速的肿瘤。