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July 25, 1994

Esophageal Disease in Human Immunodeficiency Virus Infection

Author Affiliations

From the Division of Gastrointestinal and Liver Diseases, Department of Medicine, University of Southern California School of Medicine, Los Angeles.

Arch Intern Med. 1994;154(14):1577-1582. doi:10.1001/archinte.1994.00420140042005

Up to 40% of patients with the acquired immunodeficiency syndrome may develop symptoms of esophageal disease. Candida esophagitis is responsible for the majority of the cases of esophageal disease; cytomegalovirus, herpes simplex, idiopathic esophageal ulcers, and Kaposi's sarcoma account for most of the remaining cases. Although endoscopy with esophageal biopsy and brushing is the gold standard for the diagnosis of esophageal disease in the acquired immunodeficiency syndrome, we generally recommend initial empiric therapy with an antifungal agent in patients with esophageal symptoms. Since effective treatment is available for most cases of esophageal disease in the acquired immunodeficiency syndrome, we recommend endoscopic evaluation in patients who do not respond to empiric therapy within 1 to 2 weeks. (Arch Intern Med. 1994;154:1577-1582)