Skip to main content
SpringerLink
Log in

HIV Disease

  • Chapter
  • First Online:
Geriatric Gastroenterology

  • 2385 Accesses

Abstract

Gastrointestinal manifestations are commonly present in HIV-infected individuals. In patients with AIDS, symptoms are often caused by opportunistic infections such as Cytomegalovirus, Candida albicans, herpes simplex virus, mycobacterial, fungal, or parasitic infections. Furthermore, common diseases such as gastroesophageal reflux disease, chronic hepatitis, as well as side effects of medications can manifest in any stage of HIV illness. Although the advent of potent antiretroviral therapy has brought about many changes, the global AIDS epidemic continues to afflict older adults, making it an important element in geriatrics. Clinical features, physical examination, and detailed history help narrow the differential, but laboratory, histological, endoscopic, and/or surgical exploration are required for a definitive diagnosis. Treating older adults with HIV is a complex task, requiring close monitoring for drug tolerance, drug interactions, and adverse drug events.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Joint United Nations Programme on HIV/AIDS (UNAIDS). The global aids epidemic: 09 global facts and figures. World Health Organization. 2009 (cited 25 Dec 2010). http://data.unaids.org/pub/FactSheet/2009/20091124_fs_global_en.pdf.

  2. Joint United Nations Programme on HIV/AIDS (UNAIDS). Global report: UNAIDS Report on the global AIDS epidemic. 2010 (cited 25 Dec 2010). http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf.

  3. US Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), HIV prevalence estimates—United States, 2006. Morbidity and mortality weekly report. 2008 (cited 25 Dec 2010). http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5739a2.htm.

  4. US Department of Health and Human Services, Centers for Disease Control and Prevention (CDC). Cases of HIV infection and AIDS in the United States and Dependent Areas, 2005. HIV/AIDS Surveillance Report. 2007 (cited 25 Dec 2010). http://www.cdc.gov/hiv/surveillance/resources/reports/2005report/.

  5. Statement of Senator Gordon H. Smith. HIV over fifty: exploring the new threat. United States Senate Special Committee on Aging, Aging hearing. 2005 (cited 25 Dec 2010). http://www.aging.senate.gov/events/hr141gs.pdf.

  6. US Department of Health and Human Services, Centers for Disease Control and Prevention. HIV surveillance report 2008. 2010 (cited 4 Jan 2011). http://www.cdc.gov/hiv/surveillance/resources/reports/2008report/.

  7. Gott CM. Sexual activity and risk-taking in later life. Health Soc Care Community. 2001;9(2):72–8.

    Article  PubMed  CAS  Google Scholar 

  8. Skiest DJ, Keiser P. Human immunodeficiency virus infection in patients older than 50 years. A survey of primary care physicians’ beliefs, practices, and knowledge. Arch Fam Med. 1997;6(3):289–94.

    Article  PubMed  CAS  Google Scholar 

  9. Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007;357(8):762–74.

    Article  PubMed  CAS  Google Scholar 

  10. Althoff KN, Gebo KA, Gange SJ, Klein MB, Brooks JT, Hogg RS, et al. CD4 count at presentation for HIV care in the United States and Canada: Are those over 50 years more likely to have a delayed presentation? AIDS Res Ther. 2010;7(1):45.

    Article  PubMed  Google Scholar 

  11. Chadborn TR, Baster K, Delpech VC, Sabin CA, Sinka K, Rice BD, et al. No time to wait: how many HIV-infected homosexual men are diagnosed late and consequently die? (England and Wales, 1993-2002). AIDS. 2005;19(5):513–20.

    Article  PubMed  Google Scholar 

  12. Chadborn TR, Delpech VC, Sabin CA, Sinka K, Evans BG. The late diagnosis and consequent short-term mortality of HIV-infected heterosexuals (England and Wales, 2000–2004). AIDS. 2006;20(18):2371–9.

    Article  PubMed  Google Scholar 

  13. Smith RD, Delpech VC, Brown AE, Rice BD. HIV transmission and high rates of late diagnoses among adults aged 50 years and over. AIDS. 2010;24(13):2109–15.

    Article  PubMed  Google Scholar 

  14. Kalayjian RC, Landay A, Pollard RB, Taub DD, Gross BH, Francis IR, et al. Age-related immune dysfunction in health and in human immunodeficiency virus (HIV) disease: association of age and HIV infection with naive CD8+ cell depletion, reduced expression of CD28 on CD8+ cells, and reduced thymic volumes. J Infect Dis. 2003;187(12):1924–33.

    Article  PubMed  Google Scholar 

  15. Shah S, Mildvan D. HIV and aging. Curr Infect Dis Rep. 2006;8(3):241–7.

    Article  PubMed  Google Scholar 

  16. Egger M, May M, Chene G, Phillips AN, Ledergerber B, Dabis F, et al. Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies. Lancet. 2002;360(9327):119–29.

    Article  PubMed  Google Scholar 

  17. Chu C, Selwyn PA. Complications of HIV infection: a systems-based approach. Am Fam Physician. 2011;83(4):395–406.

    PubMed  Google Scholar 

  18. Wallace MR, Brann OS. Gastrointestinal manifestations of HIV infection. Curr Gastroenterol Rep. 2000;2(4):283–93.

    Article  PubMed  CAS  Google Scholar 

  19. Edmunds-Ogbuokiri J. Clinically significant drug interactions in the HIV-infected elderly. HIV Clinician. 2011;23(2):12–5.

    Google Scholar 

  20. World Health Organization. WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children: WHO Press. 2007 (cited 18 Dec 2010). http://www.who.int/hiv/pub/guidelines/HIVstaging150307.pdf.

  21. Wilcox CM, Schwartz DA, Clark WS. Esophageal ulceration in human immunodeficiency virus infection. Causes, response to therapy, and long-term outcome. Ann Intern Med. 1995;123(2):143–9.

    PubMed  CAS  Google Scholar 

  22. Wilcox CM, Alexander LN, Clark WS, Thompson 3rd SE. Fluconazole compared with endoscopy for human immunodeficiency virus-infected patients with esophageal symptoms. Gastroenterology. 1996;110(6):1803–9.

    Article  PubMed  CAS  Google Scholar 

  23. Alexander LN, Wilcox CM. A prospective trial of thalidomide for the treatment of HIV-associated idiopathic esophageal ulcers. AIDS Res Hum Retroviruses. 1997;13(4):301–4.

    Article  PubMed  CAS  Google Scholar 

  24. Thompson C. Thalidomide effective for AIDS-related oral ulcers. Lancet. 1995;346(8985):1289.

    Article  PubMed  CAS  Google Scholar 

  25. Fialho AB, Braga-Neto MB, Guerra EJ, Fialho AM, Fernandes KC, Sun JL, et al. Low prevalence of H. pylori infection in HIV-positive patients in the Northeast of Brazil. BMC Gastroenterol. 2011;11:13.

    Article  PubMed  Google Scholar 

  26. Loftus CG. Gastrointestinal Infections, Clostridium difficile-Associated Disease, and Diverticular Disease. In: Hauser SC, editor. Mayo Clinic gastroenterology and hepatology board review. 4th ed. New York: Oxford University Press; 2011. p. 193–205.

    Chapter  Google Scholar 

  27. Hill A, Balkin A. Risk factors for gastrointestinal adverse events in HIV treated and untreated patients. AIDS Rev. 2009;11(1):30–8.

    PubMed  Google Scholar 

  28. Nyabilondi E, Wehbeh W, David R. HIV enteropathy: case report and review of advances in pathogenesis, diagnosis, and treatments. Infect Dis Clin Pract (Baltim Md). 2010;18(5):293–5.

    Article  Google Scholar 

  29. Beatty GW. Diarrhea in patients infected with HIV presenting to the emergency department. Emerg Med Clin North Am. 2010;28(2):299–310. Table of contents.

    Article  PubMed  Google Scholar 

  30. Abramowitz L, Benabderrahmane D, Baron G, Walker F, Yeni P, Duval X. Systematic evaluation and description of anal pathology in HIV-infected patients during the HAART era. Dis Colon Rectum. 2009;52(6):1130–6.

    Article  PubMed  Google Scholar 

  31. Nadal SR, Manzione CR, Horta S. Comparison of perianal diseases in HIV-positive patients during periods before and after protease inhibitors use: what changed in the 21st century. Dis Colon Rectum. 2008;51(10):1491–4.

    Article  PubMed  Google Scholar 

  32. Novoa AM, de Olalla PG, Clos R, Orcau A, Rodriguez-Sanz M, Cayla JA. Increase in the non-HIV-related deaths among AIDS cases in the HAART era. Curr HIV Res. 2008;6(1):77–81.

    Article  PubMed  CAS  Google Scholar 

  33. Thio CL, Seaberg EC, Skolasky Jr R, Phair J, Visscher B, Munoz A, et al. HIV-1, hepatitis B virus, and risk of liver-related mortality in the Multicenter Cohort Study (MACS). Lancet. 2002;360(9349):1921–6.

    Article  PubMed  Google Scholar 

  34. Gilson RJ, Hawkins AE, Beecham MR, Ross E, Waite J, Briggs M, et al. Interactions between HIV and hepatitis B virus in homosexual men: effects on the natural history of infection. AIDS. 1997;11(5):597–606.

    Article  PubMed  CAS  Google Scholar 

  35. Kamar N, Garrouste C, Haagsma EB, Garrigue V, Pischke S, Chauvet C, et al. Factors associated with chronic hepatitis in patients with hepatitis e virus infection who have received solid organ transplants. Gastroenterology. 2011;140(5):1481–9.

    Article  PubMed  Google Scholar 

  36. Dalton HR, Bendall RP, Keane FE, Tedder RS, Ijaz S. Persistent carriage of hepatitis E virus in patients with HIV infection. N Engl J Med. 2009;361(10):1025–7.

    Article  PubMed  CAS  Google Scholar 

  37. Amarapurkar AD, Sangle NA. Histological spectrum of liver in HIV - autopsy study. Ann Hepatol. 2005;4(1):47–51.

    PubMed  Google Scholar 

  38. Aaron L, Saadoun D, Calatroni I, Launay O, Memain N, Vincent V, et al. Tuberculosis in HIV-infected patients: a comprehensive review. Clin Microbiol Infect. 2004;10(5):388–98.

    Article  PubMed  CAS  Google Scholar 

  39. Enns R. AIDS cholangiopathy: “an endangered disease”. Am J Gastroenterol. 2003;98(10):2111–2.

    PubMed  Google Scholar 

  40. Winbladh A, Gullstrand P, Svanvik J, Sandstrom P. Systematic review of cholecystostomy as a treatment option in acute cholecystitis. HPB (Oxford). 2009;11(3):183–93.

    Article  Google Scholar 

  41. Dal Maso L, Franceschi S. Epidemiology of non-Hodgkin lymphomas and other haemolymphopoietic neoplasms in people with AIDS. Lancet Oncol. 2003;4(2):110–9.

    Article  PubMed  Google Scholar 

  42. Cranston RD, Hart SD, Gornbein JA, Hirschowitz SL, Cortina G, Moe AA. The prevalence, and predictive value, of abnormal anal cytology to diagnose anal dysplasia in a population of HIV-positive men who have sex with men. Int J STD AIDS. 2007;18(2):77–80.

    Article  PubMed  CAS  Google Scholar 

  43. US Department of Health and Human Services, Centers for Disease Control and Prevention (CDC). HIV/AIDS Surveillance Report U.S. HIV and AIDS cases reported through December 1999;11(2):5–44 (cited 5 Jan 2011). http://www.cdc.gov/hiv/topics/surveillance/resources/reports/pdf/hasr1102.pdf.

  44. Dworkin MS, Williamson JM. AIDS wasting syndrome: trends, influence on opportunistic infections, and survival. J Acquir Immune Defic Syndr. 2003;33(2):267–73.

    Article  PubMed  Google Scholar 

  45. Wilcox CM, Rodgers W, Lazenby A. Prospective comparison of brush cytology, viral culture, and histology for the diagnosis of ulcerative esophagitis in AIDS. Clin Gastroenterol Hepatol. 2004;2(7):564–7.

    Article  PubMed  Google Scholar 

  46. Thom K, Forrest G. Gastrointestinal infections in immunocompromised hosts. Curr Opin Gastroenterol. 2006;22(1):18–23.

    PubMed  Google Scholar 

  47. Nguyen N, Holodniy M. HIV infection in the elderly. Clin Interv Aging. 2008;3(3):453–72.

    PubMed  Google Scholar 

  48. Blanshard C. Gastrointestinal manifestations of HIV infection. Hosp Med. 1999;60(1):24–8.

    PubMed  CAS  Google Scholar 

  49. Lewthwaite P, Gill GV, Hart CA, Beeching NJ. Gastrointestinal parasites in the immunocompromised. Curr Opin Infect Dis. 2005;18(5):427–35.

    Article  PubMed  Google Scholar 

  50. Becker S. Liver toxicity in epidemiological cohorts. Clin Infect Dis. 2004;38 Suppl 2:S49–55.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Robert Wood Johnson School of Medicine, Drexel University School of Medicine, Philadelphia, USA

    C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF (Clinical Professor of Medicine)

  2. New York Medical College, Vallhala, NY, USA

    C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF (Adjunct Professor of Medicine)

  3. Gastroenterology, Hepatology and Nutrition, Saint Peter’s University Hospital, New Brunswick, NJ, USA

    C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF (Chief)

  4. Department of Medicine, Division of Gastroenterology, North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA

    Alexander Brun MD

Authors
  1. C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alexander Brun MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF .

Editor information

Editors and Affiliations

  1. Hospital, Department of Medicine, Saint Peter’s University, 254 Easton Ave, New Brunswick, 08901, New Jersey, USA

    C. S. Pitchumoni

  2. (North Division), Department of Medicine, Montefiore Medical Center, 600 East 233rd Street, Bronx, 10466, New York, USA

    T. S. Dharmarajan

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Pitchumoni, C.S., Pitchumoni, C.S., Pitchumoni, C.S., Brun, A. (2012). HIV Disease. In: Pitchumoni, C., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1623-5_71

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-1623-5_71

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-1622-8

  • Online ISBN: 978-1-4419-1623-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation