Is there a role for barium esophagogram in patients with HIV and esophageal symptoms?
Barium esophagogram has a limited role in patients with AIDS. Given that infections and neoplasms are the most common cause of disease in patients with significant immunodeficiency (CD4 count < 100), endoscopic inspection with tissue acquisition with biopsy or brushings is mandatory for a specific diagnosis. In addition, some of these disorders have a similar appearance radiographically, and toxicity can be associated with treatments directed at these infections. Thus a specific diagnosis is mandatory before empiric therapy is given. Motility disorders and reflux may be important to exclude in HIV-infected patients without immunodeficiency.