Gastrointestinal Pathology in Hiv-Infected Patients

Clayton, Frederic; Clayton, Carol H.

doi:10.1016/s0889-8553(05)70293-4

Cited by 21 publications

(16 citation statements)

References 175 publications

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“…Histopathologic features of HSV are more evident in biopsies from ulcer edges, as opposed to ulcer bases, and include necrosis, acute and chronic inflammation, and diagnostic nuclear changes (Figure 2). HSV cytopathic effect encompasses (i) homogenous ground-glass nuclei with margination of chromatin, (ii) nuclear molding, (iii) multinucleation, and, rarely, (iv) Cowdry type A nuclear inclusions [5]. Moreover, HSV-induced ulceration exhibits an inflammatory infiltrate rich in neutrophils and histiocytes, the presence of which should prompt a thorough search for viral cytopathic changes [2].…”

Section: Resultsmentioning

confidence: 99%

Human Immunodeficiency Virus-Associated Gastrointestinal Disease: Common Endoscopic Biopsy Diagnoses

Bhaijee

Subramony

Tang

et al. 2011

Pathology Research International

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The gastrointestinal (GI) tract is a major site of disease in HIV infection: almost half of HIV-infected patients present with GI symptoms, and almost all patients develop GI complications. GI symptoms such as anorexia, weight loss, dysphagia, odynophagia, abdominal pain, and diarrhea are frequent and usually nonspecific among these patients. Endoscopy is the diagnostic test of choice for most HIV-associated GI diseases, as endoscopic and histopathologic evaluation can render diagnoses in patients with non-specific symptoms. In the past three decades, studies have elucidated a variety of HIV-associated inflammatory, infectious, and neoplastic GI diseases, often with specific predilection for various sites. HIV-associated esophageal disease, for example, commonly includes candidiasis, cytomegalovirus (CMV) and herpes simplex virus (HSV) infection, Kaposi's sarcoma (KS), and idiopathic ulceration. Gastric disease, though less common than esophageal disease, frequently involves CMV, Mycobacterium avium-intracellulare (MAI), and neoplasia (KS, lymphoma). Small bowel biopsies and intestinal aspirates from HIV-infected patients often show HIV enteropathy, MAI, protozoa (Giardia, Isospora, Cryptosporidia, amebae, Microsporidia), and helminths (Strongyloides stercoralis). Colorectal biopsies demonstrate viral (CMV, HSV), bacterial (Clostridia, Salmonella, Shigella, Campylobacter), fungal (cryptococcosis, histoplasmosis), and neoplastic (KS, lymphoma) processes. Herein, we review HIV-associated GI pathology, with emphasis on common endoscopic biopsy diagnoses.

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Section: Resultsmentioning

confidence: 99%

Human Immunodeficiency Virus-Associated Gastrointestinal Disease: Common Endoscopic Biopsy Diagnoses

Bhaijee

Subramony

Tang

et al. 2011

Pathology Research International

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“…[12,13] The interesting feature of our case is that our patient did not have a documented HIV infection. Instead, it was his clean medical record as well as the radiologic diagnosis of intussusception that prompted us to undertake further serologic tests and eventually to establish the diagnosis.…”

Section: Discussionmentioning

confidence: 78%

Intussusception, the First Sign in a Patient With Intestinal Lymphoma Due to Aids a Rare Case Report

P¹,

Karuppasamy²,

K³

et al. 2016

jemds

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Although, intussusception is a common cause of intestinal obstruction in children, it is a rare event in the adult population. It has long been known that various acquired immune deficiency syndrome related conditions of the bowel such as lymphoma, lymphoid hyperplasia, cytomegalovirus colitis and Kaposi's sarcoma can lead to intussusception. The diagnosis is particularly difficult in this population of patients due to the non-specific nature of the symptoms as well as the depressed immune response obscuring inflammation or ischemia. Though the reported acquired immune deficiency syndrome associated cases of intussusception refer to patients with known human immunodeficiency virus infection, in our case we present an intestinal intussusception as the first manifestation of human immunodeficiency virus infection. CASE PRESENTATIONA 50-year-old heterosexual woman with a clean medical record and no history of abdominal operation presented to our ER with symptoms and signs suggestive of bowel obstruction. Plain abdominal radiographs were highly suspicious for intussusception, which we confirmed on a computed tomography scan. The patient was prepared for surgery and on routine investigations before surgery serology confirmed retroviral disorder, the patient was operated 3 days later and this confirmed the diagnosis of small-bowel invagination due to a 4cm polypoid growing intraluminal tumor, the pathologic examination of which revealed a diffuse high-grade B cell lymphoblastic lymphoma. CONCLUSIONHuman immunodeficiency virus infection may have a silent course and gastrointestinal manifestations of the disease leading to intussusception might be the first clinical sign. Patients with intestinal intussusception and the presence of risk factors for human immunodeficiency virus infection should be eligible for serologic tests for human immunodeficiency virus infection.

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“…In "invasive" diarrhea there are more often pathological impurities in stools as mucus and blood, patients have pain in the lower abdominal and/or permanent and unproductive defecation urgency (tenesmus) [4,10]. The most common HIV-associated pathogens, causing acute diarrhea, regardless of CD4 cells count are: viruses (Adeno-, Astro-, Picorna-, Calici-), Clostridium diffi cile, Salmonella spp., Shigella spp., Campylobacter jejuni, Escherichia coli O157: H 7 [4,7,9,10,13]. Respectively, the most common infectious agents of the chronic diarrhea, regardless of the number of CD4 cells, are: Clostridium diffi cile, Giardia lamblia, Entamoeba histolytica.…”

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confidence: 99%

“…In establishing the appropriate microorganism an etiological treatment is held. In negative culture tests for stool samples, the best comprehensive diagnostic test is colonoscopy with terminal ileal intubation and biopsy [4,7]. For patients with CD4 cell count between 100-200/mm3, it is enough to perform fl exible sigmoidoscopy and biopsy, because CMV infection is less likely to occur at higher CD4 count [7,9].…”

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confidence: 99%

“…In negative culture tests for stool samples, the best comprehensive diagnostic test is colonoscopy with terminal ileal intubation and biopsy [4,7]. For patients with CD4 cell count between 100-200/mm3, it is enough to perform fl exible sigmoidoscopy and biopsy, because CMV infection is less likely to occur at higher CD4 count [7,9]. To establish intestinal protozoa is necessary to examine the stools with specifi c staining methods: Ziehl-Neelsen, Giemsa, Heidenhain, Masson [1,5,6,8].…”

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confidence: 99%

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Etiologic Characteristics of Enterocolitis in Hospitalized HIV-Infected Patients for 3-Year Period (2013-2015)

Yancheva¹,

Strashimirov²,

Elenkov³

et al. 2016

Acta Medica Bulgarica

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Summary. Diarrhea is the most common gastrointestinal symptom in HIV-infected patients. The incidence and severity of diarrhea increase with progression of the immune defi ciency. In the literature, 30-60% of the patients with diarrhea among HIV-infected individuals remain without specifi ed etiological agent. The aim of this article is to present the incidence of enterocolitis among hospitalized HIV-infected patients over a 3-year period and the degree of etiological clarifi cation of the cause. The results of our analyses showed that 63% of the hospitalized HIV-infected patients for this period were with enterocolitis. Only in 30% of these patients etiological agent was isolated. The reasons for this are mainly fi nancial constraints and, therefore, virological investigations and further endoscopic and histopathological examination of the patients with negative for bacteria and parasites stool samples, were not performed. In the cases with isolated pathogen, an etiological treatment was carried out in parallel with highly active antiretroviral therapy, while in unsubstantiated cases an empirical treatment was carried out. Advanced immune defi ciency was associated with more severe course and worse prognosis of the enterocolitis. The treatment with highly active antiretroviral therapy, which leads to improvement of the immune status of the patients, is essential for the output of enterocolitis in HIV-infected patients.

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Gastrointestinal Pathology in Hiv-Infected Patients

Cited by 21 publications

References 175 publications

Human Immunodeficiency Virus-Associated Gastrointestinal Disease: Common Endoscopic Biopsy Diagnoses

Human Immunodeficiency Virus-Associated Gastrointestinal Disease: Common Endoscopic Biopsy Diagnoses

Intussusception, the First Sign in a Patient With Intestinal Lymphoma Due to Aids a Rare Case Report

Etiologic Characteristics of Enterocolitis in Hospitalized HIV-Infected Patients for 3-Year Period (2013-2015)

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