非人类免疫缺陷病毒患者的病毒性食道炎:一个病例控制研究
Ahmad Al-Dwairy1, Loai Azar1, Tarek Bakain1
1Department of Medicine, MedStar/Georgetown Washington Hospital Center, Washington, DC, USA.
Translational gastroenterology and hepatology
|May 8, 2024
概括
病毒性食道炎 (VE) 影响非艾滋病毒感染者,其中单纯疹病毒 (HSV) 和细胞巨乳病毒 (CMV) 是常见的原因. 虽然免疫抑制是一种危险因素,但许多患者缺乏可识别的原因,这凸显了进一步研究的必要性.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 病毒学 病毒学
背景情况:
- 食道炎是一种食道炎症,原因多种多样,包括反流,感染和过敏.
- 传染性食道炎,特别是由简单疹病毒 (HSV) 或细胞巨乳病毒 (CMV) 引起的病毒性食道炎 (VE),是一个重大问题.
- 虽然通常与免疫抑制有关,但在免疫能力强的人群中越来越多地报告了VE.
研究的目的:
- 在非艾滋病毒感染者中调查病毒性食道炎 (VE) 的风险因素和患者人口统计数据.
- 了解与HSV和CMV食道炎相关的临床表现和内镜发现.
- 在非艾滋病毒患者队列中识别VE的潜在风险因素.
主要方法:
- 一项病例控制研究从2009年到2022年通过组织病理学和免疫组织化学识别了50例VE病例 (HSV,CMV).
- 对照组的选择是基于消化管胃管腺镜 (EGD) 进行的,结果为 VE 阴性.
- 通过图表审查收集了有关人口统计,并发病症,实验室参数,内镜发现和风险因素的数据.
主要成果:
- 在HSV食道炎中,血凝较为常见,而在CMV食道炎中,消化不良占主导地位.
- 在HSV病例中,是EGD的主要发现 (67%),而在CMV病例中发现食道炎 (37%).
- 免疫抑制疗法,器官移植,恶性瘤和类固醇使用与VE有关,但34%的人没有明确的危险因素.
结论:
- 这些发现提高了对非艾滋病毒患者的VE的理解,有助于早期检测和管理.
- 识别特定的风险因素,如免疫抑制,对于有针对性的 VE 干预至关重要.
- 需要进一步研究免疫能力强的个体中VE发病率的上升以及优化治疗.
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