GASTROENTEROLOGY ARTICLE OF THE WEEK
September 11, 2008
Wilcox CM, Saag MS. Gastrointestinal complications of HIV infection: changing priorities in the HAART era. Gut 2008;57:861-870.
1. The CD-4 level threshold above which opportunistic infections become less common in HIV patients is
a. 50
b. 75
c. 500
d. 200
2. The most common cause of diarrhea in HAART treated patients is
a. C. difficile colitis
b. Cryptosporidia
c. Drug-induced diarrhea, usually from NNRTI
d. Drug-induced diarrhea, usually from PI
e. Bacterial pathogens such as Shigella and Salmonella
True or False
3. HAART therapy clearly results in lower morbidity and mortality from viral-related liver disease
4. The immune suppression associated with HIV infection results in a milder degree of liver damage from chronic HCV infection
5. HIV patients with advanced immunodeficiency and diarrhea who have negative stool studies for pathogens rarely benefit from endoscopic evaluation with biopsy
6. Multiple biopsies (>10) of the abnormal esophagus is more sensitive than culture for detection of esophageal CMV infection
7. MAC is an uncommon cause of cause of GI infections and is usually found in advanced HIV disease with CD-4 counts <50 in patients who have never received HAART
8. A normal sigmoidoscopy virtually excludes CMV infection as the vast majority of cases involve the rectum and sigmoid
9. The presence of HCV infection increases the risk of hepatotoxic reactions to HAART medications
10. HIV infection with CD-4 counts <250/mm3 should be treated prior to initiating antiviral therapy for hepatitis B infection
11. The authors of this article cannot spell hepatology terms: “pegalated”, “entocavir”, “lamuvidine”