Rabeneck L, Popovic M, Gartner S, McLean D M, McLeod W A, Read E, Wong K K, Boyko W J
Division of Gastroenterology, St Paul's Hospital, Vancouver, Canada.
JAMA. 1990 May 2;263(17):2318-22.
We describe an acute human immunodeficiency virus (HIV) infection in 16 homosexual men who presented with painful swallowing (odynophagia). Eleven men had a maculopapular rash and 3 had palatal ulcers. At esophagogastroduodenoscopy (endoscopy), multiple discrete esophageal ulcers measuring 0.3 to 1.5 cm in diameter were observed. Electron microscopy of biopsy specimens taken from the ulcer margins in 8 men revealed viral particles 120 to 160 nm in diameter whose morphologic characteristics were those of retroviruses. Human immunodeficiency virus seroconversion was documented in 15 men by Western blot analysis. In 3 men, HIV-1 was isolated from peripheral blood mononuclear cells, in 2 men HIV-1 was isolated from peripheral blood monocytes, and in 1 man HIV-1 was isolated from tissue taken from the margins of the esophageal ulcers. These observations extend our knowledge of the clinical spectrum of acute HIV infection syndromes and suggest that cells in the esophagus are a target for HIV-1 infection.
我们描述了16名出现吞咽疼痛（吞咽困难）的同性恋男性的急性人类免疫缺陷病毒（HIV）感染情况。11名男性有斑丘疹，3名有腭部溃疡。在食管胃十二指肠镜检查（内镜检查）时，观察到多个直径为0.3至1.5厘米的离散性食管溃疡。对8名男性溃疡边缘活检标本进行电子显微镜检查，发现直径为120至160纳米的病毒颗粒，其形态特征符合逆转录病毒。通过蛋白质印迹分析，15名男性被证明发生了HIV血清转化。3名男性的外周血单个核细胞中分离出HIV-1，2名男性的外周血单核细胞中分离出HIV-1，1名男性的食管溃疡边缘组织中分离出HIV-1。这些观察结果扩展了我们对急性HIV感染综合征临床谱的认识，并表明食管中的细胞是HIV-1感染的靶标。
