Acquired immunodeficiency syndrome and cytomegalovirus gastritis in a patient with decompensated liver cirrhosis and hepatocellular carcinoma: Report of a case

Human immunodeficiency virus type 1 infection is emerging as an important infectious disease since 1980s. Cytomegalovirus is a widely distributed human pathogen and clinically apparent cytomegalovirus disease is rare and usually occurs in patients with acquired immunodeficiency syndrome. Cytomegalovirus infection of the alimentary canal has many clinical and radiologic manifestations, the most common being erosion and ulceration, but no characteristic picture is noted. Serologic study is not diagnostic and confirmation of cytomegalovirus infection always depends on histology examination. We reported a hepatitis B cirrhotic patient with Child's class C liver function and hepatocellular carcinoma, who suffered from gastritis and gastric ulcer with cytomegalovirus infection. Human immunodeficiency virus type 1 infection and acquired immunodeficiency syndrome were therefore disclosed. Both ganciclovir and foscarnet are effective agents but the myelosuppressive and central nervous system adverse effects make their use not safe in this patient with suppressed liver reserve because of pancytopenia and hepatic encephalopathy. The presence of unusual or refractory ulceration in the gastrointestinal tract should be care to have the possibility of infection with human immunodeficiency virus type 1.