7112 Colonoscopic aspects of cytomegalovirus colitis in aids patients.

OBJECTIVES Diarrhea in AIDS patients is one of the most important and disabling symptom, and often decreases their quality of life. Cytomegalovirus colitis is among the principal causes of this sympton, and colonoscopy is the gold standard examination to diagnose it. The objetive of this study is to define the main endoscopic findings in AIDS patients with CMV colitis. PATIENTS AND METHODS On two hundred forty five colonoscopies perfomed in AIDS patients, over a ten year period, sixty two examinationts in fifty one patients diagnosed cytomegalovirus colitis. Full length colonocopy with ileum intubation and multiple biopsies of all segments examined were always attempted. All diagnoses were confirmed by histologic and inmunohistochemical studies. RESULTS Total colonoscopy was possible in 97,5% of these examinations, and ileum intubation was achieved in 87,2% of them. A heterogeneous ulcerative pattern was present in 82% of these cases and in 50% of then only the proximal segments were affected. The cytomegalovirus was also found in one patient with normal mucosa on total endoscopic examination. In 10% of these exams another infectious agent was observed. CONCLUSION We may conclude that full length colonoscopy with ileum intubation and multiple biopsies of all segments, even if they are endoscopically normal, has always to be attempted in all cases of AIDS patients with diarrhea.