Role of upper gastrointestinal endoscopy with routine standardized endoscopic biopsy in AIDS

Background: The purpose of this study is to identify lesions in the esophagus, stomach and duodenal bulb in patients with AIDS through endoscopy, and to correlate the results obtained with the histophatological study of standardized endoscopic biopsies of the esophagus, stomach and duodenal bulb. Methods: Eight standardized endoscopic biopsies were taken at every endoscopic examination: two from the distal segment of the esophagus, two from the body of the stomach, two from the gastric antrum and two from the duodenal bulb. The biopsies specimens were stained with H&E, Ziehl-Nielsen-Faraco, Giemsa and periodic acid-schiff dyes. The avidin-biotin-peroxidase method was used for the immunohistochemical study. Results: Endoscopy with standardized endoscopic biopsies of the upper gastrointestinal tract in patients with AIDS demonstrated specific findings in the esophagus at 24.1% of cases, 16.1% in the stomach and 8.0% in the duodenal bulb. Endoscopy with standardized endoscopic biopsies of the gastrointestinal tract in patients with AIDS, even with normal endoscopic appearance, displayed specific findings in the stomach at 27.7% and in the duodenal bulb at 27.7%. Conclusion: Quite often, the endoscopic features in the esophagus, stomach and duodenal bulb in patients with AIDS do not appear to be associated with pathogens identified in them. Although we do not have data at this time, this series opens the discussion and shows that, even in patients with AIDS presenting a normal endoscopic finding, performing standardized endoscopic biopsies for the detection of opportunistic infections in various segments of the gastrointestinal tract could be very important.