Document 2962
 DOCN  M94A2962
 TI    Endoscopy studies of AIDS: the 90's versus the 80's.
 DT    9412
 AU    Bernal A; Frazier R; Del Junco G; Gathe J Jr; Piot D; Special Diseases
       Unit, Park Plaza Hospital, Houston, Texas.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):185 (abstract no. PB0170). Unique
       Identifier : AIDSLINE ICA10/94369613
 AB    OBJECTIVE: A comparative study of the endoscopic findings of AIDS in the
       90's vs. the early 80's. Those years precluded antiretroviral therapy as
       well as most of the primary and secondary prophylaxis of opportunistic
       infections. To analyze the impact, if any, of those measures on the
       epidemiology and clinical spectrum in GI diseases. METHOD: Retrospective
       review of 263 gastroscopies and 226 colonoscopies in 321 HIV+
       individuals from 1990 to 1993. Review of data from an earlier study,
       demographically comparable with regard to age, sex, and risk factor of
       174 patients from 1982 to 1985, is presented as the last percentage in
       brackets. Gastric emptying studies were also performed with a mixture of
       2 mCl 99mTc sulfur colloid with scrambled eggs. RESULTS: All of the 321
       cases reviewed met the CDC criteria of AIDS. There were 318 males and 3
       females; mean age was 36.7 years. Risk factors included homosexuality in
       303 cases, bisexuals 10 cases, intravenous drug use (IVDU) in 3, blood
       transfusions in 2 cases. Candida esophagitis was the most frequent
       findings (46 = 14.3% (80's = 23%) Giant ulcer of the esophagus, 6 of
       which were CMV proven (26 = 8%) (4%). CMV gastritis and colitis (54 =
       16.9%) (6.8%). Intestinal mycobacteria were found in (23 = 7.1%) (1.3%).
       Cryptosporidia in (17 = 5.29%) (1.3%); Gastrointestinal KS could be
       diagnosed in (27 = 8.4%) (28%); Non-Hodgkins lymphoma endoscopically in
       (1 = .3%) (5.7%). Significant delay of gastric emptying manifested by
       gastric bezoar, > 200 ml or isotopic studies were seen in (33 = 10.3%)
       (0%). CONCLUSIONS: Endoscopic evaluation of AIDS patients continues to
       be helpful for diagnosis and proper management. A distinct trend in
       presentation seems to be evolving as compared to early years.
       Candidiasis of esophagus is decreasing probably due to prophylaxis with
       antifungal agents. CMV of the gastrointestinal tract is on the increase
       despite specific antiviral agents (gancyclovir and foscarnet). This may
       be due in part to viral resistance or different viral strains. KS
       continues to decline but this started in mid 80's for unclear reasons.
       The increased presence of delay in gastric emptying defies any clear
       explanation. Progress in opportunistic infection therapy with longer
       life expectancy and more concomitant MAIC infections could be the base,
       however, further studies seem warranted. Is the HIV virus itself the
       culprit?
 DE    Adult  AIDS-Related Opportunistic Infections/DIAGNOSIS/*EPIDEMIOLOGY
       Cross-Sectional Studies  *Endoscopy, Gastrointestinal  Female  Gastric
       Emptying/PHYSIOLOGY  Gastrointestinal Diseases/DIAGNOSIS/*EPIDEMIOLOGY
       Gastrointestinal Neoplasms/DIAGNOSIS/*EPIDEMIOLOGY  Human  Incidence
       Lymphoma, AIDS-Related/DIAGNOSIS/*EPIDEMIOLOGY  Male  Retrospective
       Studies  Texas/EPIDEMIOLOGY  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).