Hello NP, I present a question that is worthy of your professional medical interpretation and feedback and of which is beneficial to the public. A medical article posted at Medscape.com announced that upper gastrointestinal tract symptoms were quite prevalent in HIV infected people. Are there other diseases such as CMV that could be the cause of this Upper GI problem? Thank You, D.S.

Hello The upper gastrointestinal tract can be the source of many different problems for folks with HIV disease/AIDS. Most people with HIV disease usually suffer from upper GI problems at some point during their disease process. The major factor influencing GI complications is the integrity of the immune system. Folks with higher CD4 counts and suppressed viral load levels tend to have fewer upper gastrointestinal problems. The mouth has always been a helpful gauge in identifying immune suppression. Fungal infections, hairy leukoplakia, herpes, apthous ulcers and gingivitis can be markers of immune suppression. Difficulty with and/or a burning sensation while swallowing can indicate a fungal infection of the esophagus, which occurs with immune suppression. CMV and herpes infections of the esophagus can usually occur mostly in those with profound immune suppression. Fortunately, these problems occur much less frequently since the advent of better treatments with HAART