[Manifestations of AIDS in the gastrointestinal tract]

Besides central nervous system, pulmonary and cutaneous manifestations, the gastrointestinal tract and the hepatobiliary system are major organs in AIDS. Gastrointestinal symptoms due to opportunistic infections or HIV-associated tumours are common in AIDS patients. Nevertheless, a huge variety of endoscopically diagnosed mucosal lesions may not always be correlated to microbiological findings, clinical symptoms and histological aspects. Cytomegalovirus being the most important opportunistic infection in the GI tract in symptomatic AIDS patients, is correlated with erosive and ulcerative lesions, often accompanied by complications like perforation or bleeding. HIV-associated tumours in the GI tract like Non Hodgkin-lymphoma or Kaposi sarcoma may present with atypical endoscopic findings. Diagnostic procedures should include microbiological and histological investigations of biopsies looking for opportunistic infections. Besides, typical immunological changes involving the mucosa as direct target organ of the HIV virus, are important to understand morphological and functional abnormalities in HIV-patients with GI symptoms.