Oesophageal Ulceration in Human Immunodeficiency Virus Infected Patients

Abstract

Objectives
To determine the aetiology of oesophageal ulceration in HIV infected patients.

Design
Retrospective clinical, endoscopic and histopathological analysis of patients with confirmed HIV infection and an oesophageal ulcer diagnosed at endoscopy.

Setting
A tertiary referral, gastrointestinal clinic, Cape Town.

Results
Fifty one patients with HIV infection and oesophageal ulceration were seen from January 2001 to December 2007. Median CD4 count was 53.1 cells/mm3. Mean age was 35.5 years. Sixty percent of patients were female. Forty nine percent of cases were due to idiopathic oesophageal ulcers while 23% were due to cytomegalovirus infection. The remainder were due to miscellaneous causes.

Conclusions
A surprisingly small number of patients with HIV associated oesophageal ulceration were seen during the study period. This may reflect local referral practices or alternatively patients with severe immune suppression succumb before developing oesophageal ulcers. As in other series, idiopathic oesophageal ulcers and cytomegalovirus ulcers made up the majority of cases. Correct biopsy technique and appropriate histological and microbiological investigations are associated with improved diagnostic yield in these patients