Acquired immune deficiency syndrome is the final stage of human immunodeficiency virus disease. The diagnosis of AIDS indicates that an individual has tested positive for HIV with acute damage to the immune system and a CD4 lymphocyte count less than 200 cells per mcL. Additional criteria for AIDS includes a higher incidence of infections, such as tuberculosis, and malignancies, such as invasive cervical cancer. Digestive problems result from numerous causes including infections, increased metabolic rate, malabsorption and the effects of the virus.
Human Immunodeficiency Virus
Acute HIV infection, if left untreated, develops into AIDS. The virus invades the immune system, increasing susceptibility to a variety of infections and cancers. Ordinary organisms, such as bacteria, yeasts, viruses and parasites, that do not cause serious illnesses become life-threatening diseases with AIDS. Many of these organisms attack areas throughout the digestive system, causing local and systemic infections. The resulting symptoms of infection affect chewing, swallowing and digestion as well as absorption of medications and valuable nutrients, vitamins and minerals.
Symptoms
Some symptoms common to HIV and AIDS occur as a result of the virus and without infection from opportunistic organisms. The symptoms include fever, weight loss, chills, swollen lymph nodes, weakness and night sweats. Anorexia, nausea, vomiting and diarrhea are common with AIDS and lead to reduced caloric intake, weight loss and muscle wasting. For some individuals, AIDS increases metabolism and worsens the side effects of low-caloric intake, but treating fevers and secondary infections can lower the metabolic rate and slow weight loss and wasting.
Candidal Esophagitis
Candida albicans, a fungus, is part of normal oral flora, but it becomes an opportunistic infection in the presence of HIV and AIDS. Candida causes yellow-white plaques that stick to the oral mucous membranes and sometimes extend into the esophagus. Symptoms of an infection include difficult and painful chewing and swallowing that results in decreased nutritional intake. Clotrimazole lozenges and nystatin suspensions treat oral candida infections but esophageal infections require systemic treatment with antifungals.
Enterocolitis
Enterocolitis, inflammation of the lining of the small and large intestine, is frequently associated with HIV itself, but it also results from secondary infections from bacteria and viruses. Individuals with AIDS tend to develop more chronic and severe symptoms including high fevers, acute abdominal pain and profuse watery diarrhea. Therapy consists of identifying the causative organism, if present, with stool cultures, antibiotics, and symptomatic treatment for fever, pain and diarrhea.
Additional Conditions
Some individuals with AIDS do not make normal amounts of stomach acid and are not able to break down and absorb medications that need an acid medium to dissolve, a condition called gastropathy. The lower levels of stomach acid can also result in increased infections with certain organisms, such as Salmonella and Shigella, that are sensitive to acid levels. Malabsorption syndrome, common in AIDS, can result from intestinal infections as well as the chronic enterocolitis that is associated with HIV itself.
References
- "Current Medical Diagnosis & Treatment"; HIV Infections & AIDS; Andrew R. Zolopa and Mitchell H. Katz; 2008
- Medline Plus: AIDS
- National Institute of Allergy and Infectious Disease: HIV/AIDS
- Wake Med Health & Hospitals: AIDS
