HIV & Gastrointestinal System

A patient came to the OPD with the complaint of multiple episodes of watery diarrhea. He was diagnosed with HIV and was not taking any medications. Which of the following is the most common cause of diarrhea in such patients?

A 40-year-old male presented with a diagnosis of HIV for the past 6 years. He presented to the emergency department with severe epigastric pain radiating to the back associated with nausea and vomiting for the previous 2 days. He has a history of poor medication adherence and recently resumed didanosine, lamivudine, and efavirenz. On examination, he was irritable, with tenderness in the epigastric region and hypoactive bowel sounds. Investigations showed elevated serum lipase and amylase. Which of the following is the most likely cause of the patient’s current presentation?

A 48-year-old man presented with complaints of watery diarrhea for 6 months. He has lost 8 kg during this period. Investigations showed a positive HIV antibody test. His hemoglobin was 10 g/dl, and albumin was 3.2. His stool examination showed multiple red-staining cysts on a modified ZN stain. What will be the most appropriate treatment for him?

A 40-year-old male with a 7-year history of HIV presents to the emergency department with a 2-week history of abdominal pain, chronic diarrhea with occasional blood, and unintentional weight loss. He also reports low-grade fever and fatigue. He admits to poor adherence to antiretroviral therapy (ART) over the past year. His most recent CD4 count, checked 3 months ago, was 45 cells/mm³.

On physical examination, he appears cachectic, with diffuse abdominal tenderness, especially in the lower abdomen. Rectal examination shows mild tenderness but no obvious masses. Laboratory tests reveal normocytic anemia and mild leukopenia. Stool analysis is negative for bacterial pathogens and ova/cysts. Colonoscopy reveals multiple large, shallow ulcers with erythematous borders throughout the colon. Biopsy from the ulcer edge shows large cells with basophilic intranuclear inclusions surrounded by a clear halo. What is the most likely diagnosis?

A 38-year-old male with a 5-year history of HIV presents to the clinic with complaints of persistent high-grade fever, night sweats, chronic watery diarrhea, and significant weight loss (10 kg over the past 2 months). He also reports generalized fatigue and abdominal discomfort. He has been non-adherent to his antiretroviral therapy (ART) for the past year.

On examination, the patient appears cachectic and pale. Vital signs reveal a temperature of 38.5°C (101.3°F). There is hepatosplenomegaly on abdominal palpation, but no focal tenderness. There are no focal neurological deficits or lymphadenopathy.

Laboratory findings include:

• Hemoglobin: 8.2 g/dL (normocytic, normochromic anemia)
• White blood cell count: 4,000/µL
• CD4 count: 25 cells/mm³
• Elevated alkaline phosphatase and lactate dehydrogenase (LDH)
• Negative stool cultures and tests for ova and parasites

Which of the following is the most likely diagnosis?

A 40-year-old male patient with a history of HIV infection and poor adherence to antiretroviral therapy presents with a one-month history of dysphagia. Endoscopic examination reveals shallow, well-defined ulcers in the distal third of the esophagus. What is the most probable diagnosis in this case?

A 35-year-old patient who resided in Dubai for 5 years presented with difficulty swallowing. He labeled these symptoms as due to a prolonged sore throat. The patient also experienced decreased visual acuity for the previous few weeks. Further inquiry revealed the patient had diarrhea for the preceding 5 months and had tried some homeopathic medications. The patient was diagnosed with viral retinitis during the evaluation of the decreased visual acuity. On examination, white patches were observed on the tongue. Upper gastrointestinal endoscopy suggested esophagitis with no ulcers, and gastric washing showed hyphae. Which of the following is most likely cause of dysphagia in this patient?