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Value of laboratory investigations in clinical suspicion of cytomegalovirus‐induced upper gastrointestinal tract ulcerations in HIV‐infected patients
Author(s) -
DorigoZetsma J.W.,
van der Meer J.T.M.,
Tersmette M.,
ten Kate F.J.W.,
Wertheimvan Dillen P.M.E.,
van der Noordaa J.
Publication year - 1996
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/(sici)1096-9071(199605)49:1<29::aid-jmv5>3.0.co;2-m
Subject(s) - cytomegalovirus , gastrointestinal tract , virology , human immunodeficiency virus (hiv) , medicine , viral disease , immunology , herpesviridae
To assess the value of laboratory investigations for the diagnosis and treatment of cytomegalovirus‐induced upper gastrointestinal tract ulcerations, the medical records and biopsy material from HIV‐infected patients were reviewed retrospectively during a 12‐month period. Clinical diagnosis of cytomegalovirus (CMV) ulceration, based on characteristic endoscopic appearance of extensive ulceration of the mid‐ to distal esophageal or gastric mucosa and responsiveness to anti‐CMV therapy, was compared with laboratory investigations of biopsies. Laboratory procedures consisted of both histopathological examination of the biopsy specimens and viral culture. Twenty episodes in 12 HIV‐infected patients could be evaluated. Clinical diagnosis of CMV ulceration appeared to be justified in 14 of 20 episodes (70%), which were confirmed by laboratory investigations. Of the remaining six episodes, which showed partial or no response to anti‐CMV therapy, laboratory investigations were negative in two episodes and discrepant in four episodes (histopathology or viral culture positive). A good response to anti‐CMV therapy was more frequent in patients whose biopsies proved positive by histopathological examination and/or viral culture than in patients with negative tests (82% versus 0%), which indicates the importance of both investigations. In conclusion, laboratory diagnosis of CMV‐induced upper gastrointestinal tract ulcerations supported the diagnosis and decisions on treatment of CMV‐induced upper gastrointestinal tract ulcerations. © 1996 Wiley‐Liss, Inc.