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May 27, 1996

Ulcerative Esophagitis During Primary HIV Infection

Arch Intern Med. 1996;156(10):1115. doi:10.1001/archinte.1996.00040041115016

I diopathic esophageal ulcers affect 10% of the patients with human immunodeficiency virus (HIV) who present with esophageal symptoms.1 It has been suggested that the HIV itself might be the cause,2 although this is not universally accepted.3 We therefore consider it of interest to present a case of ulcerative esophagitis that developed during primary HIV infection. Report of a Case. A 30-year-old heterosexual woman with no toxic habits presented with dysphagia, odynophagia, mouth ulcers, maculopapular exanthem, and laterocervical lymphadenopathy. The peripheral white blood cell count was 4.3×109/L; absolute lymphocytes, 1.8×109/L; CD4 cells, 0.85×109/L; CD8 cells, 0.64×109/L; and CD4/CD8 ratio, 0.01. The immunoglobulin and β2-microglobulin concentrations were normal. There was no serological indication of acute infection due to syphilis, hepatitis A, hepatitis B, Epstein-Barr virus, cytomegalovirus, measles, herpes simplex, or rubella. Serological tests were also negative for HIV antibodies and positive for HIV p24 antigen. Endoscopy revealed longitudinal, superficial