IDIOPATHIC ULCERATIONS OF THE ESOPHAGUS IN HIV-INFECTED PATIENTS - A REVIEW

A clinical syndrome of large ulcerations of the oesophagus has been we ll described in the literature in HIV-infected patients. These patient s are markedly symptomatic with odynophagia and substernal chest pain as their most common presenting symptoms. Weight loss often accompanie s this disorder. Despite biopsy evaluation for patients with idiopathi c oesophageal ulcerations, no identifiable cause of this lesion is fou nd. Although some authors suggest that these ulcerations represent a p rimary HIV infection of the oesophagus, others question the role of HI V itself in the development of these lesions. Patients with this disor der appear to respond to corticosteroid therapy in the oral, intraveno us or intralesional form. This therapy could possibly predispose to in fectious complications. Acute HIV infection has also been described pr esenting with lesions of the oesophagus which may be single or multipl e. It has again been suggested that HIV is the primary aetiology of th e oesophageal ulcerations. Endoscopic evaluation is mandatory for the diagnosis of idiopathic oesophageal ulcerations of the oesophagus in H IV-infected patients. It is important to rule out the many other cause s of oesophageal ulcerations in these patients, as treatment modalitie s are determined by proper diagnosis of the underlying disorder.