HIV/AIDS infection: endoscopic characteristics of the most common esophageal lesions and propaedeutics

Abstract

Introduction: The gastrointestinal tract is one of the main sites of disease in human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). In this article we will address esophageal disease associated with HIV, with emphasis on its endoscopic and histopathological find­ings. Objectives: The objective of this review is to describe the characteristics of the main endoscopic findings of the esophagus associated with HIV/AIDS, with emphasis on diagnosis and management in the face of macroscopic findings. Methods: Review of the medical literature of articles selected from PubMed. Results: The most common esophageal lesions associated with HIV/AIDS are candida esoph­agitis, Cytomegalovirus (CMV) infections, herpes simplex virus (HSV) and idiopathic ulceration. The most common clinical condition is the development of acute symptoms, such as dysphagia and odyno­phagia, leading to a reduction in food intake, worsening the clinical condition of immunosuppressed patients due to the worsening of nutritional status. The best diagnostic test is upper digestive endosco­py, which allows the evaluation of the esophageal mucosa and collection of biopsies for histopathology. Conclusion: Clinical suspicion of esophageal lesions, during upper digestive endoscopy in patients without a diagnosis of HIV infection and careful observation of esophageal lesions, with correct ac­quisition of material for study in patients known to be infected or not, can modify treatment and the patient with HIV/AIDS’s prognosis.