Diagnosis and treatment of esophageal diseases in patients with acquired immunodeficiency syndrome in Serbia

Abstract

Introduction. Gastrointestinal complications are common manifestations of acquired immune deficiency syndrome. The aim of this study was to establish the type and frequency of esophageal disease, the influence of antiretroviral therapy on it and the most adequate approach to this group of patients. Material and methods. This study included 146 patients with acquired immune deficiency syndrome treated at the Institute of Infectious and Tropical Diseases of Clinical Centre in Serbia from 1991-2001. The statistical data processing was done by the Statistical Package for the Social Sciences for Windows version 10.0. The level of statistical significance was defined to be p?0.05 and p?0.01. The diagnosis was made upon endoscopic exams, pathohistological findings and isolation of causative agents. Results. Esophagitis was found in 78 (53.41%) patients. These patients complained mostly of odynophagia and dysphagia. The most common was Candida esophagitis. It was diagnosed in 59 (40.41%) patients; 5 patients (3.42%) had cytomegalovirus esophagitis; 2 patients (1.37%) had herpes simplex virus esophagitis, and one-patient (0.68%) had a mixed Candida and herpes simplex virus infection of esophagus. Idiopathic esophageal ulcer was diagnosed in one (0.68%) patient. Conclusion. Seventy-eight (53.41%) patients with acquired immune deficiency syndrome had esophagitis. Candida (40.41%) was the most common cause of esophagitis. Viral esophagitis was less common: cytomegalovirus in 5 patients (3.42%); herpes simplex virus in 2 patients (1.37%), and idiopathic esopghageal ulcer in 1 patient (0.68%)). These patients complained mostly of odynophagia and dysphagia. Modern antiretroviral therapy reduces the frequency of esophagitis and therefore changes symptomatology in patients with acquired immune deficiency syndrome.