2 Responses to “Sedating HIV-Infected Endoscopy Patients”
M. Brian Fennerty, MD
Founding Editor
NEJM Journal Watch Gastroenterology
Learn more about Gut Check on Gastroenterology.
From NEJM: Recently in Gastroenterology- Type 1 Autoimmune Pancreatitis August 6, 2026A 60-year-old man presented with a 1-month history of postprandial epigastric pain. CT of the abdomen showed a diffusely enlarged pancreas with a capsule-like rim. Serum levels of IgG4 were elevated.
- Iptacopan in IgA Nephropathy — Final 24-Month Data July 30, 2026Alternative complement pathway overactivation contributes to IgA nephropathy. In a placebo-controlled trial, iptacopan, a complement factor B inhibitor, significantly slowed kidney-function decline in patients with IgA nephropathy.
- Pulsatile Liver in Severe Tricuspid Regurgitation July 30, 2026A 51-year-old woman with right heart failure presented with worsening abdominal distention and leg swelling. Examination was notable for ascites, leg edema, a grade 4/6 holosystolic murmur, and a pulsatile liver (shown in a video).
- Breaking the RAS Barrier in Pancreatic Cancer July 23, 2026For decades, pancreatic ductal adenocarcinoma (PDAC) has been perhaps the clearest example of a cancer that is driven by a dominant oncogenic event yet is resistant to therapeutic exploitation. More than 90% of pancreatic cancers harbor activating RAS mutations, most commonly those involving KRAS codon 12,...
- National Elimination of Hepatitis C — The Case for Starting in Prisons and Jails July 23, 2026The United States could take meaningful steps toward eliminating hepatitis C by broadly testing and treating people who are involved in the criminal legal system.
- Type 1 Autoimmune Pancreatitis August 6, 2026
Brian, thanks for getting this issue out there to your GI colleagues. We have a meeting with the group in charge of policy on “conscious sedation,” and this specific question will be discussed — hope to get it resolved.
Just for the record, our HIV patients now have a projected life expectancy estimated to be decades — cancer screening recommendations that apply to HIV negative patients apply equally to them. Furthermore, the vast majority of HIV patients on antiviral therapy are receiving either efavirenz or ritonavir, so this issue of sedation for colonoscopies is a highly relevant question.
Propofol