HIV-associated Ulcers
Laura W. Lamps, MD
Key Facts
Terminology
Reportedly causes 40-50% of ulcers in HIV patients
Clinical Issues
Odynophagia, independent of food intake
Chest pain
Weight loss
Macroscopic Features
Middle esophagus most common site
Can be very large (> 3 cm)
Microscopic Pathology
Granulation tissue
Mixed acute and chronic inflammation
May extend into muscle
By definition, special stains, immunohistochemical stains, cultures must be negative
 Endoscopic photograph of a large, irregular idiopathic esophageal ulcer in an AIDS patient. (Courtesy A. Lazenby, MD.) |
 Hematoxylin & eosin of a chronic HIV-associated ulcer shows detached squamous mucosa and underlying granulation tissue with mixed inflammation. (Courtesy R. Yantiss, MD.) |
TERMINOLOGY
Synonyms
Chronic HIV-associated esophageal ulcers
Definitions
Chronic idiopathic ulcers in HIV or AIDS patients
Other underlying pathogens have been rigorously excluded
Reportedly causes 40-50% of ulcers in HIV patients
ETIOLOGY/PATHOGENESIS
HIV
Ability of HIV to directly produce ulcers remains controversial
However, HIV has been demonstrated within ulcers by molecular, immunohistochemical, and ELISA assays
CLINICAL ISSUES
Presentation
Odynophagia, independent of food intake
Chest pain
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