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April 1992

Upper Gastrointestinal Disease in Human Immunodeficiency Virus— Infected Individuals

Author Affiliations

Houston, Tex

Arch Intern Med. 1992;152(4):881-882. doi:10.1001/archinte.1992.00400160161040

To the Editor——  The experience of Bonacini et al1 in identifying the causes of esophageal symptoms in human immunodeficiency virus (HIV)-infected individuals is remarkably similar to our experience at the Institute for Immunological Disorders in Houston, Tex. We examined 34 consecutive HIVinfected patients who presented with odynophagia or dysphagia in a manner similar to that described by Bonacini et al. Twenty-two patients (65%) were documented to have an esophageal infection. Fourteen patients (41%) had Candida esophagitis alone, four (12%) had Candida and cytomegalovirus, two (6%) had cytomegalovirus alone, and two patients (6%) had herpes simplex virus infection alone (Table). Of the 12 patients in whom an infectious agent could not be determined, two had esophageal involvement with Kaposi's sarcoma and the rest had nonspecific findings and remained without diagnosis. None of our patients had bacterial, mycobacterial, protozoal, or fungal (other than Candida species) infections of the esophagus.We also