Variations in the Clinical Course of Patients with Herpes Simplex Virus Esophagitis Based on Immunocompetence and Presence of Underlying Esophageal Disease

Patrick Hoversten, Amrit K. Kamboj, Tsung-Teh Wu, David A Katzka

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and Aims: Herpes simplex esophagitis (HSE) is the second most common cause of infectious esophagitis and occurs in both immunocompetent and immunocompromised patients. The aim of this study was to reappraise the clinical course of HSE in different patient populations based on degree of immunocompetence and the presence or absence of underlying esophageal disease. Methods: Patients with histopathologically confirmed HSE identified from the Mayo Clinic pathology database from 2006 to 2016 were included in this study. Relevant demographic, clinical, and endoscopic data were retrospectively reviewed and compared between two cohorts: (a) immunocompromised and immunocompetent patients and (b) patients with and without underlying esophageal disorders. Results: Forty-six patients were included in the study. The most common presenting symptoms were odynophagia (34.8%) and dysphagia (30.4%). Thirty-three (71.7%) patients were immunocompromised, and these patients who experienced longer duration of symptoms (25.5 ± 23.4 days vs. 7.0 ± 5.5 days, p = 0.04) were more likely to require an extension of treatment course (38.1% vs. 8.3%, p = 0.05) compared to their immunocompetent counterparts. Seventeen (37%) patients had underlying esophageal disease, and these patients were more likely to have concomitant esophageal candidiasis (41.2% vs. 10.3%, respectively; p = 0.01). Conclusion: Herpes simplex virus causes esophagitis in both immunocompetent and immunocompromised patients. While the disease course appears to be self-limited for all patient populations, clinical and endoscopic differences in the disease presentation and clinical course based on immune status and the presence or absence of underlying esophageal disease exist.

Original languageEnglish (US)
JournalDigestive Diseases and Sciences
DOIs
StatePublished - Jan 1 2019

Fingerprint

Esophageal Diseases
Immunocompetence
Esophagitis
Simplexvirus
Immunocompromised Host
Herpes Simplex
Candidiasis
Deglutition Disorders
Population
Demography
Databases
Pathology

Keywords

  • Endoscopy
  • Esophagitis
  • HSV
  • Immunodeficiency

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

Cite this

@article{b8762775c8c142f297844b84cf0f6810,
title = "Variations in the Clinical Course of Patients with Herpes Simplex Virus Esophagitis Based on Immunocompetence and Presence of Underlying Esophageal Disease",
abstract = "Background and Aims: Herpes simplex esophagitis (HSE) is the second most common cause of infectious esophagitis and occurs in both immunocompetent and immunocompromised patients. The aim of this study was to reappraise the clinical course of HSE in different patient populations based on degree of immunocompetence and the presence or absence of underlying esophageal disease. Methods: Patients with histopathologically confirmed HSE identified from the Mayo Clinic pathology database from 2006 to 2016 were included in this study. Relevant demographic, clinical, and endoscopic data were retrospectively reviewed and compared between two cohorts: (a) immunocompromised and immunocompetent patients and (b) patients with and without underlying esophageal disorders. Results: Forty-six patients were included in the study. The most common presenting symptoms were odynophagia (34.8{\%}) and dysphagia (30.4{\%}). Thirty-three (71.7{\%}) patients were immunocompromised, and these patients who experienced longer duration of symptoms (25.5 ± 23.4 days vs. 7.0 ± 5.5 days, p = 0.04) were more likely to require an extension of treatment course (38.1{\%} vs. 8.3{\%}, p = 0.05) compared to their immunocompetent counterparts. Seventeen (37{\%}) patients had underlying esophageal disease, and these patients were more likely to have concomitant esophageal candidiasis (41.2{\%} vs. 10.3{\%}, respectively; p = 0.01). Conclusion: Herpes simplex virus causes esophagitis in both immunocompetent and immunocompromised patients. While the disease course appears to be self-limited for all patient populations, clinical and endoscopic differences in the disease presentation and clinical course based on immune status and the presence or absence of underlying esophageal disease exist.",
keywords = "Endoscopy, Esophagitis, HSV, Immunodeficiency",
author = "Patrick Hoversten and Kamboj, {Amrit K.} and Tsung-Teh Wu and Katzka, {David A}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s10620-019-05493-x",
language = "English (US)",
journal = "Digestive Diseases and Sciences",
issn = "0163-2116",
publisher = "Springer New York",

}

TY - JOUR

T1 - Variations in the Clinical Course of Patients with Herpes Simplex Virus Esophagitis Based on Immunocompetence and Presence of Underlying Esophageal Disease

AU - Hoversten, Patrick

AU - Kamboj, Amrit K.

AU - Wu, Tsung-Teh

AU - Katzka, David A

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background and Aims: Herpes simplex esophagitis (HSE) is the second most common cause of infectious esophagitis and occurs in both immunocompetent and immunocompromised patients. The aim of this study was to reappraise the clinical course of HSE in different patient populations based on degree of immunocompetence and the presence or absence of underlying esophageal disease. Methods: Patients with histopathologically confirmed HSE identified from the Mayo Clinic pathology database from 2006 to 2016 were included in this study. Relevant demographic, clinical, and endoscopic data were retrospectively reviewed and compared between two cohorts: (a) immunocompromised and immunocompetent patients and (b) patients with and without underlying esophageal disorders. Results: Forty-six patients were included in the study. The most common presenting symptoms were odynophagia (34.8%) and dysphagia (30.4%). Thirty-three (71.7%) patients were immunocompromised, and these patients who experienced longer duration of symptoms (25.5 ± 23.4 days vs. 7.0 ± 5.5 days, p = 0.04) were more likely to require an extension of treatment course (38.1% vs. 8.3%, p = 0.05) compared to their immunocompetent counterparts. Seventeen (37%) patients had underlying esophageal disease, and these patients were more likely to have concomitant esophageal candidiasis (41.2% vs. 10.3%, respectively; p = 0.01). Conclusion: Herpes simplex virus causes esophagitis in both immunocompetent and immunocompromised patients. While the disease course appears to be self-limited for all patient populations, clinical and endoscopic differences in the disease presentation and clinical course based on immune status and the presence or absence of underlying esophageal disease exist.

AB - Background and Aims: Herpes simplex esophagitis (HSE) is the second most common cause of infectious esophagitis and occurs in both immunocompetent and immunocompromised patients. The aim of this study was to reappraise the clinical course of HSE in different patient populations based on degree of immunocompetence and the presence or absence of underlying esophageal disease. Methods: Patients with histopathologically confirmed HSE identified from the Mayo Clinic pathology database from 2006 to 2016 were included in this study. Relevant demographic, clinical, and endoscopic data were retrospectively reviewed and compared between two cohorts: (a) immunocompromised and immunocompetent patients and (b) patients with and without underlying esophageal disorders. Results: Forty-six patients were included in the study. The most common presenting symptoms were odynophagia (34.8%) and dysphagia (30.4%). Thirty-three (71.7%) patients were immunocompromised, and these patients who experienced longer duration of symptoms (25.5 ± 23.4 days vs. 7.0 ± 5.5 days, p = 0.04) were more likely to require an extension of treatment course (38.1% vs. 8.3%, p = 0.05) compared to their immunocompetent counterparts. Seventeen (37%) patients had underlying esophageal disease, and these patients were more likely to have concomitant esophageal candidiasis (41.2% vs. 10.3%, respectively; p = 0.01). Conclusion: Herpes simplex virus causes esophagitis in both immunocompetent and immunocompromised patients. While the disease course appears to be self-limited for all patient populations, clinical and endoscopic differences in the disease presentation and clinical course based on immune status and the presence or absence of underlying esophageal disease exist.

KW - Endoscopy

KW - Esophagitis

KW - HSV

KW - Immunodeficiency

UR - http://www.scopus.com/inward/record.url?scp=85061201170&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061201170&partnerID=8YFLogxK

U2 - 10.1007/s10620-019-05493-x

DO - 10.1007/s10620-019-05493-x

M3 - Article

C2 - 30725296

AN - SCOPUS:85061201170

JO - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

SN - 0163-2116

ER -