Gastrointestinal complications of HIV infection: changing priorities in the HAART era

Abstract

It has now been some 25 years since the initial description of AIDS. Following these observations, the epidemiology, natural history and manifestations of this disease have been well characterised. Intense investigation has better characterised HIV, resulting in the development of effective drug therapies to arrest disease progression. These multidrug combinations, termed highly active antiretroviral therapy or HAART, can suppress the viral load to the undetectable range and secondarily halt the destruction of CD4 T lymphocytes. This virological response is associated with a marked improvement in survival and absence of the many complications related to immunodeficiency. For patients who respond to HAART, the current emphasis is on treating side effects from the medications as well as treating other non-AIDS-related disorders. However, given the cost and complexities of these regimens, there are many patients who continue to present with the classic manifestations of AIDS, and, especially in the developing world, we will continue to see these patients for years to come.

Role of upper endoscopy in diagnosing opportunistic infections in human immunodeficiency virus-infected patients

“…The tropism of many pathogens for the squamous mucosa of the esophagus (Candida, herpesviruses), as well the appearance of new diseases (idiopathic esophageal ulceration) has established the upper GI tract as a common site for complications [8] . Upper endoscopy with mucosal biopsies is a standard part of the evaluation of upper GI symptoms in these cases, especially because the therapy will depend on the specific pathogen found.…”

The new epidemic of non-communicable disease in people living with the human immunodeficiency virus [Perspective]

“…Researchers and funding bodies should be encouraged to partner and implement quality research studies on emergent NCDs in those settings where disease occurs. 8 Lung cancer Cardiac 9 Coronary artery disease Dyslipidaemia Dilated cardiomyopathy Endocrine 10 Insulin resistance 11 Metabolic syndrome Thyroid disease Hypogonadism Addison's disease Gastrointestinal 12 HIV cholangiopathy Pancreatitis Neurological 13 Antiretroviral toxic neuropathy HIV dementia Minor cognitive motor disorder Musculoskeletal 14 Joint malignancy Osteonecrosis Hypertrophic osteoarthropathy Myositis Opthalmological Uveitis Retinal microvasculopathy HIV = human immunodeficiency virus.…”

Úlceras esofágicas em portadores do Vírus da Imunodeficiência Humana: etiologia e análise comparativa entre métodos diagnósticos

“…A Síndrome da Imunodeficiência Adquirida (AIDS) é uma das mais devastadoras pandemias da história baseada não somente na sua distribuição mundial, mas também por sua letalidade (WILCOX &SAAG, 2008).…”

“…Na África subsaariana, região onde 10% da população do mundo reside, a prevalência da infecção pelo HIV varia de 10 a 20% (WILCOX & SAAG, 2008 …”

“…A endoscopia digestiva alta (EDA) em portadores do HIV sintomáticos possibilita um diagnóstico específico em aproximadamente 75% dos casos (WILCOX & SAAG, 2008).…”