An endoscopic and pathological survey of digestive tract disorders in patients infected with human immunodeficiency virus monitored in the Clinic of Infectious Diseases from Tirgu Mures, Romania.

UNLABELLED: Gastrointestinal symptoms are among the most frequent complaints of patients infected with human immunodeficiency virus (HIV).

PURPOSE: An endoscopic and histopathological survey of digestive tract diseases among HIV-infected patients monitored in the Clinic of Infectious Diseases I from Tirgu Mures, Romania.

MATERIALS AND

METHODS

Retrospective, observational study, on a group of 38 HIV-positive patients admitted to the Clinic of Infectious Diseases I from Tirgu Mures, Romania, during 2006-2013, undergoing upper/lower endoscopy. We collected data regarding the results of endoscopy and histopathological examination, CD4+ T-lymphocytes levels, microbiological examinations and outcome. Statistical analysis, performed by using Microsoft Office Excel 2007 and GraphPad Prism 5 programs, included contingency tables analysis and comparing means.

RESULTS

Our study depicted a variety of digestive disorders among HIV-infected patients, ranging from opportunistic infections to HIV enteropathy and non-HIV-associated conditions. The presence of Candida esophagitis implied significantly lower levels of CD4+ T-cells (p=0.0043). We found a statistically significant negative association between antiretroviral therapy and the presence of opportunistic infections (p=0.0375, OR=0.2030, 95% CI 0.0423-0.9741). Thirteen (34.21%) patients died, mostly due to tuberculosis and central nervous system infections. All were diagnosed with acquired immunodeficiency syndrome (AIDS).

CONCLUSIONS

HIV-infected patients experience a wide variety of digestive tract disorders, both AIDS-defining illnesses and non-HIV-associated conditions. Gastrointestinal opportunistic infections occur more often among patients with low CD4+ T-cells levels and in those not receiving antiretroviral therapy. Although digestive conditions did not represent direct causes of death in our study, they may predict an unfavorable outcome in AIDS-stage patients.