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Dysphagia in HIV

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Dysphagia in HIV, Odynophagia in HIV

  • See Also
  1. Dysphagia
  2. Gastrointestinal Manifestations of HIV
  3. HIV Complications
  • Epidemiology
  1. Dysphagia or odynophagia occurs in 40-50% HIV patients
  • Causes
  1. Candida most frequent pathogen (50-70% of cases)
  2. Viral (30% of cases)
    1. Herpes Simplex Virus
    2. Cytomegalovirus Infection
  3. Polymicrobial: 20-25% cases
  4. Aphthous Ulcer or pill-induced ulcers (less frequent)
  • Signs
  1. Mucosal Plaques, erosions or ulcerations
  2. External compression from nodes or masses
  3. Oral Thrush
    1. Indicator (70-80%) for esophageal involvement
    2. Oral Thrush seen in 62% of Esophageal Candidiasis
  • Diagnosis
  • Endoscopy
  1. Biopsy and brushings
  2. Culture for virus, Mycobacterium, and fungus
  • Management
  1. Anti-Candida treatment can be tried
  2. Failure to respond in 24-48 hours requires endoscopy