Vega K J, Bollu J, Dajani E Z, Trotman B W
Gastroenterology Division/Department of Medicine, LMDNJ-New Jersey, Medical School 07103, USA.
J Assoc Acad Minor Phys. 1996;7(4):93-8.
Esophageal disease is a common and important cause of morbidity and mortality in patients with human immunodeficiency virus (HIV) infection. The etiology of HIV-related esophageal ulceration varies. After all known etiologies are excluded, a subgroup of patients remains with esophageal ulceration known as idiopathic esophageal ulceration (IEU). Establishing a diagnosis of IEU is critical and precludes unnecessary treatment with antiviral, antifungal, or antibiotic agents. A review of the current literature indicates that there are no prospective, placebo-controlled, randomized, double-blind trials on the specific treatment of IEU. Several preliminary reports suggest that corticosteroids and thalidomide may be effective. The incidence and natural history of IEU are incompletely known. It is important to establish that any potential therapeutic agents employed to treat IEU do not increase viral replication or provide viral protection. There is a need for well-designed, placebo-controlled, prospective studies to assess the risks and benefits of corticosteroids, thalidomide, and other agents in the treatment of idiopathic esophageal ulceration.
食管疾病是人类免疫缺陷病毒（HIV）感染患者发病和死亡的常见且重要原因。HIV相关食管溃疡的病因各不相同。在排除所有已知病因后，仍有一部分食管溃疡患者，称为特发性食管溃疡（IEU）。确立IEU的诊断至关重要，可避免对抗病毒、抗真菌或抗生素药物进行不必要的治疗。对当前文献的回顾表明，尚无关于IEU特异性治疗的前瞻性、安慰剂对照、随机、双盲试验。一些初步报告表明，皮质类固醇和沙利度胺可能有效。IEU的发病率和自然史尚不完全清楚。必须确定用于治疗IEU的任何潜在治疗药物不会增加病毒复制或提供病毒保护。需要进行精心设计的、安慰剂对照的前瞻性研究，以评估皮质类固醇、沙利度胺和其他药物治疗特发性食管溃疡的风险和益处。
