Gastrointestinal Manifestations of HIV

Aka: Gastrointestinal Manifestations of HIV, HIV-related Gastrointestinal Conditions

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II. Differential Diagnosis

  1. Infectious Esophagitis, Gastroenteritis and colitis
    1. Dysphagia in HIV (or Odynophagia in HIV)
    2. Nausea in HIV (or Vomiting in HIV)
    3. Gastritis in HIV
    4. Gastric Outlet Obstruction in HIV
    5. Diarrhea in HIV
  2. Infiltrative hepatobiliary infections
    1. AIDS Cholangiopathy
    2. Hepatitis in HIV
    3. Peliosis Hepatitis
  3. Infiltrative pancreatic infections
    1. Pancreatitis in HIV
  4. Rectal lesions
    1. Genital Warts (especially anorectal warts)
    2. Anorectal lesions (consider Colorectal Cancer)
  5. Medication adverse effects: Antiretroviral therapy
    1. Nausea, Dyspepsia and Diarrhea
      1. Common adverse effects (esp. Protease Inhibitors)
      2. Inquire about side effects at each visit to prevent non-compliance
    2. Hepatotoxicity
      1. Protease Inhibitors (esp. older agents)
      2. Nevirapine (NNRTI)
    3. Withdrawal of NRTI (Emtricitabine, Lamivudine, Tenofovir)
      1. Agents have activity against Hepatitis B Infection (in addition to HIV Infection)
      2. Hepatitis BVirus Infection may flare when these medications are stopped

III. References

  1. Chu (2017) Am Fam Physician 96(3): 161-9 [PubMed]

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