ENDOSCOPIC FINDINGS IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS

Silvio Cesar Pereira FRAGOSO; Renata Roana Silva Mendonca MILHOMEM; Marcela Haiberlin Montaldi Lopes ALBONETTE; Plinio dos Santos RAMOS; Luiz Carlos BERTGES

Volume : VIII, Issue : III, March - 2019

ENDOSCOPIC FINDINGS IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS

Silvio Cesar Pereira Fragoso, Renata Roana Silva Mendonca Milhomem, Marcela Haiberlin Montaldi Lopes Albonette, Plinio Dos Santos Ramos, Luiz Carlos Bertges

Abstract :

Introduction: The gastrointestinal tract is a major source of disease in patients with human immunodeficiency virus. In addition to opportunistic infections, immunosuppression also predisposes patients to neoplasias, with Kaposi‘s sarcoma being the most common. Objective: To describe the frequency of various endoscopic findings in patients with HIV and determine whether they are associated with viral load, CD4+ cell count and use of antiretroviral therapy. Material and Methods: A retrospective study was performed using medical records of HIV–positive patients treated at the Doctor Heitor Vieira Dourado Tropical Medicine Foundation from January to August 2017. Data were collected on gender, age, diagnosis time, antiretroviral use, CD4+ T cell count, viral load and the endoscopic findings of each patient. The data were analyzed and reported as descriptive statistics. Results: The most frequent endoscopic finding was Helicobacter pylori, although a relationship between the presence of this bacterium and HIV infection was not established. Candida esophagitis was the second most frequent finding, with cytomegalovirus and herpetic esophagitis identified as well. Other opportunistic infections coincident with immunosuppression and low CD4+ cell count were also identified, such as hookworm, cryptosporidiosis and histoplasmosis. Six neoplasms were identified, with three being classified as Kaposi‘s sarcoma, which is a very common type of cancer in immunosuppressed individuals. Conclusion: The most common endoscopic findings were Helicobacter pylori and candida esophagitis. These, as well as other opportunistic diseases diagnosed, were found more frequently in patients with increased viral load and CD4+ T cell counts less than 200 cells/mm3. Endoscopy is important for the early diagnosis of these pathologies and may reduce secondary complications and thus reduce the morbidity and mortality of these patients.