Document Detail


Herpes simplex esophagitis in patients with AIDS: report of 34 cases. The Cooperative Study Group on Herpetic Esophagitis in HIV Infection.
MedLine Citation:
PMID:  8783688     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Herpetic esophagitis (HE) associated with human immunodeficiency virus (HIV) is a rare condition mainly reported as isolated cases. We thus decided to study this association and analyze the possible predisposing factors, clinical and endoscopic presentations, and clinical response to treatment. Thirty-four HIV-1-infected patients were identified: 27 had histologically or virologically confirmed HE and seven had probable HE, a retrospective diagnosis based on the efficacy of acyclovir given alone. The median CD4 cell count was 15/mm3. Recent predisposing factors (such as nasogastric procedures, steroid therapy, and anticancer therapy) were noted with regard to 16 of the 34 patients (47%). Odynophagia and/or chest pain occurred in 30 patients (88%). At the time of diagnosis of HE, extraesophageal herpes was found in only 13 patients (38%). Superficial ulcers of the distal third of the esophagus were present in 17 (50%). Among 20 of the 27 patients with confirmed HE that could be evaluated, therapy with acyclovir led to complete resolution in 16 and partial response in 3; 1 patient died of HE. Five patients (15%) suffered confirmed or possible relapses. The mean interval between the diagnosis of HE and death was 8.8 months. Herpes simplex virus may be responsible for ulcerated esophagitis that occurs in the advanced stages of AIDS and that can be safely treated with acyclovir before a definitive diagnosis is made.
Authors:
T Généreau; O Lortholary; O Bouchaud; F Lacassin; P Vinceneux; P De Truchis; A Jaccard; J L Meynard; R Verdon; D Sereni; C Marche; J P Coulaud; L Guillevin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  22     ISSN:  1058-4838     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1997-01-08     Completed Date:  1997-01-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  926-31     Citation Subset:  IM; X    
Affiliation:
Service de Médecine Interne, Hôpital Avicenne, Université Paris-Nord, Bobigny, France.
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / microbiology*
Acquired Immunodeficiency Syndrome / complications*
Acyclovir / therapeutic use
Adrenal Cortex Hormones / adverse effects
Adult
Aged
Antineoplastic Agents / adverse effects
CD4 Lymphocyte Count
Esophagitis / complications*,  diagnosis,  drug therapy
Esophagoscopy
Female
Herpes Simplex / etiology*,  immunology
Humans
Intubation, Gastrointestinal / adverse effects
Male
Middle Aged
Recurrence
Retrospective Studies
Risk Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Antineoplastic Agents; 59277-89-3/Acyclovir

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