[Infectious esophagitis in HIV infection]

Area of Science:

• Gastroenterology
• Infectious Diseases
• Oncology

Context:

• Infectious esophagitis is a frequent digestive tract disease in patients with Acquired Immunodeficiency Syndrome (AIDS).
• Diagnosis typically involves endoscopy with mucosal brushing and biopsy for cytological, histological, and microbiological analysis.
• Candida species are the most common cause of esophagitis in Human Immunodeficiency Virus (HIV)-positive individuals, often asymptomatic and linked to oral candidiasis.

Purpose:

• To review the diagnosis and management of infectious esophagitis in patients with AIDS.
• To highlight the prevalence and diagnostic methods for Candida, Cytomegalovirus (CMV), and Herpes Simplex Virus (HSV) esophagitis.
• To propose a therapeutic strategy based on epidemiological and clinical findings.

Summary:

• Endoscopic diagnosis, with brushing often preferred over biopsy, is key for identifying pathogens like Candida, CMV, and HSV.
• CMV and HSV esophagitis diagnosis relies on identifying intranuclear inclusions or viral antigens, with antiviral therapies (ganciclovir, acyclovir) generally effective.
• Co-infections with Candida and viruses are common, while bacterial or mycobacterial causes are rare. A strategic therapeutic approach is recommended.

Impact:

• Provides a comprehensive overview of infectious esophagitis in AIDS patients, aiding clinicians in diagnosis and treatment.
• Emphasizes the importance of accurate and timely diagnosis for managing opportunistic infections in immunocompromised individuals.
• Contributes to optimizing patient care by suggesting evidence-based therapeutic strategies for a common complication of AIDS.