性行為感染症（STD）の消化管病変

Sexually Transmitted Disease (STD)―Related Digestive Tract Lesion

要旨　STDの消化管病変はHIVの出現により頻度が増加し，種類も多彩となった．HIV感染や男性同性愛者であることがわかっている場合は，頻度の高い消化管病変を念頭に置き内視鏡を行う必要がある．HIV陽性者であればCD4数で日和見感染症をある程度予想することや混合感染が多いこと，男性同性愛者であればアメーバ腸炎が多いことやSTDの混合感染や再感染もあることに留意すべきである．HIV感染や男性同性愛者であることがわかっていない場合も，STDの消化管病変の内視鏡像を熟知していれば正しい診断は可能である．内視鏡像からHIV感染を推測することも可能である．

　With the emergence of HIV, the occurrence of STD-related digestive tract lesions has increased in frequency and the types of these lesions have become diversified. Where the involvement of HIV infection or male homosexuality is known, it is necessary to perform endoscopy, keeping in mind the high incidence of digestive tract lesions. If a patient is HIV positive, it is possible to predict opportunistic infection to some extent based on the CD4 count, and to expect that many mixed infections may occur. Where male homosexuality is involved, care is necessary as there will be amebic colitis in many cases and, at the same time, there may be STD-related mixed infection and/or re-infection. Even when the involvement of HIV infection or male homosexuality is not known, it is possible to make a correct diagnosis, if the physician concerned is familiar with endoscopic pictures of digestive tract lesions. It is also possible to conjecture the presence of HIV infection from the endoscopic picture.