Outcome of AIDS-associated Cytomegalovirus Colitis in the Era of Potent Antiretroviral Therapy

Bini, Edmund J.; Gorelick, Steven M.; Weinshel, Elizabeth

doi:10.1097/00004836-200006000-00012

Cited by 20 publications

(8 citation statements)

References 33 publications

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“…In a large report of 252 AIDS patients with CMVC, 97.6% had mucosal abnormalities and 2.4% had normal mucosal aspect (5) . v. 44 -no.…”

Section: Discussionmentioning

confidence: 97%

“…CMV is the most common colonic pathogen in HIV + patients causing 5% to 10% of their colitis (17) and can be one of the pathogens in 45% of patients with severe diarrhea (33) . Colitis due to CMV usually occurs in HIV + patients with CD4 lymphocyte counts <100 cells/mm³ and has a myriad of presenting symptoms (3,5) . Patients more commonly have diarrhea, but can present abdominal pain, fever and loss of weight (21,39) .…”

Section: Introductionmentioning

confidence: 99%

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Cytomegaloviral colitis in HIV positive patients: endoscopic findings

Marques¹,

Averbach²,

Zanoni³

et al. 2007

Arq. Gastroenterol.

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-Background -Diarrhea in seropositive human immunodeficiency virus patients is one of the most important and disabling symptoms, and often decreases their quality of life. Cytomegalovirus colitis is among the principal causes of this symptom and colonoscopy is the gold standard examination to diagnose it. Aim -To define the main endoscopic findings in seropositive human immunodeficiency virus patients with cytomegalovirus colitis. Methods -Two hundred and forty-three colonoscopies were performed in 200 seropositive human immunodeficiency virus patients with diarrhea associated or not to abdominal pain or gastrointestinal bleeding, over 10-year period, whom 51 patients were diagnosed with cytomegalovirus colitis. Full length colonoscopy with ileum intubation was always tried and multiple biopsies of all segments examined, including endoscopically normal segments, were attempted. All diagnoses were confirmed by histologic and immunohistochemical studies. Results -Total colonoscopy was possible in 98.03% and ileum intubation in 88.23% of these cytomegalovirus colitis patients. At colonoscopy, a heterogeneous ulcerative pattern was presented in 72.54%, an inflammatory process of the mucosa in 21.56% and 5.88% of the patients mucosa was endoscopically normal. Conclusion -Full length colonoscopy with ileum intubation and multiples biopsies of all segments, even when they are endoscopically normal, have always to be attempted in cases of seropositive human immunodeficiency virus patient with diarrhea. HEADINGS -Acquired immunodeficiency syndrome. Colitis. Cytomegalovirus infections. Diarrhea. Colonoscopy.

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“…In a large report of 252 AIDS patients with CMVC, 97.6% had mucosal abnormalities and 2.4% had normal mucosal aspect (5) . v. 44 -no.…”

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Cytomegaloviral colitis in HIV positive patients: endoscopic findings

Marques¹,

Averbach²,

Zanoni³

et al. 2007

Arq. Gastroenterol.

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“…It may cause abdominal pain, diarrhea, and ulcers of the small intestine or colon (which can result in bleeding or perforation). Immune reconstitution with antiretroviral therapy forms the backbone of treatment [12]. Ganciclovir, 5 mg/kg intravenously over 1 hour every 12 hours for 14 days, is first-line therapy [13][14][15].…”

Section: Viral Infections Rotavirusmentioning

confidence: 99%

Small intestinal infections

Mehandru

Bini

2001

Curr Treat Options Gastro

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The differential diagnosis of small intestinal infections is broad, making the identification and management of these disorders challenging. The majority of cases of acute diarrhea are self-limited and do not require diagnostic evaluation or treatment. Most patients do not require specific therapy, and treatment should focus on fluid and electrolyte replacement. In patients with severe, persistent, or chronic diarrhea, a careful medical history and routine stool testing are helpful in determining the cause. Pathogen-specific therapy should be given in patients in whom a pathogen is identified. In those without an identifiable pathogen, antidiarrheal agents are helpful in reducing the number of bowel movements and preventing further dehydration. Endoscopy may be helpful in patients with severe diarrhea and a negative stool evaluation, particularly in HIV-infected patients with chronic diarrhea. Surgery has a limited role in the management of small intestinal infections, but may be lifesaving in patients with intestinal perforation or small bowel obstruction.

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“…Colonoscopy is widely implemented when diagnosing CMV colitis, in combination with histological findings and CMV cultures. 2,[4][5][6] Nevertheless, the exact correlation between CMV and the colonic mucosal findings remains undefined. 5 Lately, colonic CMV infection has been studied more extensively utilizing molecular biology techniques based on the polymerase are chain reaction (PCR).…”

Section: Introductionmentioning

confidence: 99%