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Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 7, 2009; 15(9): 1050-1056
Published online Mar 7, 2009. doi: 10.3748/wjg.15.1050
Role of upper endoscopy in diagnosing opportunistic infections in human immunodeficiency virus-infected patients
Ana Luiza Werneck-Silva, Ivete Bedin Prado
Ana Luiza Werneck-Silva, Casa da AIDS-Infectious Disease Division, School of Medicine, University of São Paulo, Rua Frei Caneca 255, CEP:05403-000, São Paulo, Brazil
Ivete Bedin Prado, University of São Paulo, Hospital das Clínicas da FMUSP Av. Ovídio Pires de Campos, 225, 6 andar CEP:05403-010, São Paulo, Brazil
Author contributions: Werneck-Silva AL reviewed the literature and wrote the paper; Prado IB contributed to the design of the paper, supervised the writing and corrected the paper.
Correspondence to: Ana Luiza Werneck-Silva, Rua Ourânia 100 apto 91, CEP:05445-030, São Paulo, Brazil. alwerneck@uol.com.br
Telephone: +55-11-38148919
Fax: +55-11-30919308
Received: November 25, 2008
Revised: January 6, 2009
Accepted: January 13, 2009
Published online: March 7, 2009
Abstract

Highly active antiretroviral therapy (HAART) has dramatically decreased opportunistic infections (OIs) in human immunodeficiency virus (HIV)-infected patients. However, gastrointestinal disease continues to account for a high proportion of presenting symptoms in these patients. Gastrointestinal symptoms in treated patients who respond to therapy are more likely to the result of drug-induced complications than OI. Endoscopic evaluation of the gastrointestinal tract remains a cornerstone of diagnosis, especially in patients with advanced immunodeficiency, who are at risk for OI. The peripheral blood CD4 lymphocyte count helps to predict the risk of an OI, with the highest risk seen in HIV-infected patients with low CD4 count (< 200 cells/mm3). This review provides an update of the role of endoscopy in diagnosing OI in the upper gastrointestinal tract in HIV-infected patients in the era of HAART.

Keywords: Human immunodeficiency virus, Opportunistic infections, Upper gastrointestinal tract, Gastrointestinal endoscopy, Highly active antiretroviral therapy