Dear Dr Feinberg,thanks for your wonderfull job on this forum i simply love your responses,But now i've a question. Im a 45 yrs old male diagnosed positive march this year,first Cd 4 370 (after a pyelonephritis) VL unknown after 6wk's first visit to an aids specialist vl 7200 CD-4 730 control in four months a month before the next appointment i discovered trush in my mouth an i aspect myself from esophagal trus due to swollowing complains for the last year going on and off no doctor ever payed real attention to it bet the last time my GP perscripet me nizoral and dactarin (tabs and gel) within a few days i could eat normal and the symptoms dissapear,so far so good, next visit by my aids doctor VL 12000 CD-4 600 he already wrote down next control in about six month's then he heard of my recent complains of joint pains,trush (still appeard after 4 weeks on nizoral) and he diagnosed me with hairy leukoplakia and said well then we should start therapy, well i'm on combivir/ziagen now doing well in spite off some vomiting ocassionally, but since yesterday my swolloing complains are returned should i have an esofhagoscopie to look what's really going on down there, or should i try another course of antimycotica ?? sorry for the long story again thanks for your efforts a lot of thanks from holland..

The most common cause of esophagitis in HIV+ peole is candida (thrush), but there are other causes as well, like herpes simplex. I think that having an endoscopic exam is worthwhile, so that the doctor can actually see what's going on and take a sample for further testing. Good luck!