Human Immunodeficiency Virus–Related Gastrointestinal Pathology: A Southern Africa Perspective With Review of the Literature (Part 1: Infections)

Abstract

Context.—Human immunodeficiency virus infection is rife in sub-Saharan Africa and in southern Africa in particular. Despite the increasing availability of antiretroviral therapy in this region, opportunistic infections remain common and frequently involve the gastrointestinal tract.Objective.—To review the histopathologic findings and distinguishing features of human immunodeficiency virus–associated gastrointestinal infections in southern Africa and relate those findings to the documented international literature.Data Sources.—The available literature on this topic was reviewed and supplemented with personal experience in a private histopathology practice in South Africa.Conclusions.—In southern Africa, the range of gastrointestinal, opportunistic infectious pathology in human immunodeficiency virus afflicted patients is diverse and includes viral, bacterial, fungal, and parasitic infections. This infectious pathology is sometimes a manifestation of systemic disease. In profoundly immunocompromised patients, unusual histologic features, involvement of uncommon gastrointestinal tract sites, and more than one pathogen may be seen.