Kim Hee Jin, Kim Hyun Jin
Korean J Helicobacter Up Gastrointest Res. 2024 Jun;24(2):122-126. doi: 10.7704/kjhugr.2024.0027. Epub 2024 Jun 10.
Viral infections of the upper gastrointestinal (GI) tract are not uncommon in clinical practice; however, these are frequently observed in immunocompromised patients and rarely in immunocompetent hosts. Compared with esophagitis, which may be associated with clinically significant outcomes, the stomach is a relatively rare site for opportunistic infections in immunocompetent patients. The most common clinically relevant upper GI tract viral infections include cytomegalovirus (CMV), Epstein-Barr virus (EBV), and herpes simplex virus infections. CMV esophagitis and gastritis, which primarily occur in immunocompromised patients, necessitate antiviral treatment, whereas immunocompetent patients typically respond to proton pump inhibitor administration. Most EBV-induced gastric infections are asymptomatic. However, EBV infection is a known etiological contributor to stomach cancer. EBV-associated gastric cancer shows distinctive clinical, pathological, genetic, and post-genetic mutation features and is therefore a clinically significant entity. Herpetic esophagitis usually affects immunocompromised patients and is uncommon in immunocompetent individuals. In this review, we discuss the general aspects and recent studies that have reported esophageal and gastric infections in immunocompromised patients.
上消化道(GI)病毒感染在临床实践中并不少见;然而,这些感染在免疫功能低下的患者中较为常见,而在免疫功能正常的宿主中则很少见。与可能伴有具有临床意义的后果的食管炎相比,胃在免疫功能正常的患者中是机会性感染相对罕见的部位。临床上最常见的相关上消化道病毒感染包括巨细胞病毒(CMV)、爱泼斯坦-巴尔病毒(EBV)和单纯疱疹病毒感染。CMV食管炎和胃炎主要发生在免疫功能低下的患者中,需要进行抗病毒治疗,而免疫功能正常的患者通常对质子泵抑制剂治疗有反应。大多数由EBV引起的胃部感染是无症状的。然而,EBV感染是已知的胃癌病因之一。EBV相关胃癌具有独特的临床、病理、遗传和基因后突变特征,因此是一个具有临床意义的实体。疱疹性食管炎通常影响免疫功能低下的患者,在免疫功能正常的个体中并不常见。在本综述中,我们讨论了免疫功能低下患者食管和胃部感染的一般情况及近期研究报告。