Gastrointestinal Manifestations of AIDS

by Carlo Raj, MD

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    00:01 An important topic for us to cover would actually be GI manifestations.

    00:05 That would be occurring during a patient who has AIDS.

    00:09 Viral gastroenteritis is important.

    00:13 Just like we have done earlier but the esophagus when there is an immunocompromised patient, the CMV (Cytomegalovirus) may either caused issues within the colon resulting in enteritis or perhaps esophagitis. HSV, not only with HSV and immunocompromised patient cause the esophagitis that I showed you picture of with diffused inflammation of the esophagus with endoscopy but there also be colitis in addition there´d be issues with the proctitis.

    00:50 Adenovirus: non-bloody diarrhea also part of immunocompromised patient with the viral type of enteritis. Bacterial manifestations of gastroenteritis in AIDS include the following: If the CD4 count drops below 50, you should be thinking about bacteria such as mycobacterium avium intracellulare, diarrhea, weight loss, malabsorptions. Stool cultures can be used for diagnosis.

    01:16 In addition, you will see a higher incidence of enteric bacterial infections caused by salmonella, shigella, and campylobacter.

    01:23 And while it has been said that these three specifically are the most common culprits in HIV infection diarrhea worldwide, the increased prescribing of antiretroviral medications has led to the increase in non-infectious etiologies.

    01:36 At this point due to the wide range of disease control in HIV-positive patients, it’s much better to discuss their diarrhea causes in relation to the CD4 count.

    01:46 Fungi. Candida, we´ve talked about with well, once again a couple of places.

    01:52 In an immunocompromised patient you could have Candida infection within the mouth welcome to oral thrush. You can have candidiasis of the esophagus and you might have white, yellow-like plaque such you might find on upper endoscopy.

    02:07 Also, fungi Histoplasma: colitis.

    02:12 Immunocompromised patient. Protozoa cryptosporidium parvum: Make sure you know the treatment for this.

    02:21 It is one of the most common causes of diarrhea in an AIDS patient.

    02:25 Isospora: (I would know this as well) cotrimoxazole.

    02:29 Microsporidia can be treated with Albendazole.

    02:33 Others include Entamoeba histolytica in which not only would you have diarrhea and colitis but then you might also have involvement of the liver.

    02:41 Welcome to liver abscesses. Giardia lamblia could also be found.

    02:45 Giardiasis and also what´s known as Blastocystitis hominis.

    About the Lecture

    The lecture Gastrointestinal Manifestations of AIDS by Carlo Raj, MD is from the course Small and Large Intestine Diseases: Basic Principles with Carlo Raj.

    Included Quiz Questions

    1. "Red currant jelly" stools
    2. Non-bloody diarrhea
    3. Colitis
    4. Proctitis
    5. Esophagitis

    Author of lecture Gastrointestinal Manifestations of AIDS

     Carlo Raj, MD

    Carlo Raj, MD

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