Moliya P, Singh A, Singh N, Kumar V, Sohal A. Insights into gastrointestinal manifestation of human immunodeficiency virus: A narrative review. World J Virol 2025; 14(1): 99249 [DOI: 10.5501/wjv.v14.i1.99249]
Corresponding Author of This Article
Aalam Sohal, MBBS, Academic Fellow, Department of Gastroenterology and Hepatology, Creighton University School of Medicine, 3216 NE 45th Pl Suite 212, Phoenix, AZ 85012, United States. aalamsohal@gmail.com
Research Domain of This Article
Virology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Pratiksha Moliya, Department of Transplant Hepatology, University of Nebraska Medical Center, Omaha, NE 69198, United States
Anmol Singh, Department of Medicine, Tristar Centennial Medical Center, Nashville, TN 37203, United States
Navdeep Singh, Department of Medicine, Government Medical College, Amritsar 143001, Punjab, India
Vikash Kumar, Aalam Sohal, Department of Gastroenterology and Hepatology, Creighton University School of Medicine, Phoenix, AZ 85012, United States
Co-corresponding authors: Anmol Singh and Aalam Sohal.
Author contributions: Moliya P, and Sohal A conceptualized and designed the study. Moliya P, Singh A and Singh N conducted the literature review, interpreted the data, and drafted the original manuscript; Kumar V and Sohal A supervised the study and made critical revisions. All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aalam Sohal, MBBS, Academic Fellow, Department of Gastroenterology and Hepatology, Creighton University School of Medicine, 3216 NE 45th Pl Suite 212, Phoenix, AZ 85012, United States. aalamsohal@gmail.com
Received: July 18, 2024 Revised: October 15, 2024 Accepted: November 4, 2024 Published online: March 25, 2025 Processing time: 133 Days and 1.6 Hours
Abstract
Human immunodeficiency virus (HIV) modifies CD4-positive cells, resulting in immunodeficiency and a wide range of gastrointestinal (GI) manifestations. The burden of HIV-related GI illnesses has significantly evolved with the widespread use of antiretroviral therapy (ART). While ART has effectively reduced the occurrence of opportunistic infections, it has led to an increase in therapy-related GI illnesses. Common esophageal conditions in HIV patients include gastroesophageal reflux disease, idiopathic esophageal ulcers, herpes simplex virus, cytomegalovirus (CMV), and candidal esophagitis. Kaposi’s sarcoma, a hallmark of acquired immunodeficiency syndrome, may affect the entire GI system. Gastritis and peptic ulcer disease are also frequently seen in patients with HIV. Diarrhea, often linked to both opportunistic infections and ART, requires careful evaluation. Bloody diarrhea, often a sign of colitis caused by bacterial infections such as Shigella or Clostridium difficile, is prevalent. Small bowel lymphoma, although rare, is increasing in prevalence. Anorectal disorders, including proctitis, fissures, and anal squamous cell carcinoma, are particularly relevant in homosexual men, underlining the importance of timely diagnosis. This review comprehensively explores the epidemiology, pathogenesis, and treatment considerations for the various GI disorders associated with HIV, highlighting the importance of accurate diagnosis and effective treatment to improve outcomes for HIV-infected patients.
Core Tip: Human immunodeficiency virus (HIV) modifies CD4-positive cells, causing immunodeficiency and leading to various gastrointestinal (GI) issues. Highly active antiretroviral therapy (ART) has shifted the burden of HIV-related GI illnesses, reducing opportunistic infections while increasing GI problems associated with therapy, such as gastroesophageal reflux disease, non-infectious diarrhea, and HIV enteropathy. Diarrhea, linked to both infections and ART, requires careful evaluation to identify the etiology. Conditions such as colitis-related bloody diarrhea, small bowel lymphoma, and anorectal disorders, including proctitis and anal squamous cell carcinoma, also require timely diagnosis and management, especially in at-risk populations.
