Cytomegalovirus esophagitis in an adolescent with human immunodeficiency virus infection: a clinical case

Gastrointestinal disorder is one of the main elements in a number of pathological changes characteristic of human immunodeficiency virus (HIV) infection in children. Such lesion can be caused by direct impact of the virus on the gastrointestinal tract, opportunistic infections, prolonged use of drugs (antibiotics, antivirals, antifungals).With the progression of HIV-infection, the risk of pathology of the digestive system increases. Among opportunistic diseases, a special attention should be paid to cytomegalovirus (CMV) infection, in which all the organs and systems of the child are involved in the pathological process, including the gastrointestinal tract. Esophagitis is the second most common gastrointestinal disorder after colitis in such patients. With CMV esophagitis in HIV-infected children, the clinical symptoms are nonspecific. Endoscopic examination is quite informative. Available literature contains descriptions of esophagitis in children with HIV-infection, but the focus was made on damage to the esophagus caused by fungi. The presented clinical case demonstrates the development of CMV esophagitis in an adolescent with HIV-infection. Poor patient’s adherence to therapy allowed the disease to develop naturally, with a progressive decline in the immune status, the occurrence of an opportunistic CMV infection with a predominant lesion of the esophagus and severe CMV esophagitis. The development of this complication did not make it possible to correct antiretroviral therapy. This clinical case illustrates the progressive course of HIV-infection with the development of severe CMV esophagitis in an adolescent against the background of poor adherence to antiretroviral therapy.