People with HIV may develop ulcers in the mouth or oesophagus (throat) that are caused by infections. The commonest cause of oesophageal ulcers is cytomegalovirus (CMV). Less commonly, herpes simplex virus or Candida can be the cause. Mouth ulcers may also be caused by several viral, fungal and bacterial infections.

People with HIV may also experience severe aphthous ulcers,1 which are painful lesions in the mouth and oesophagus.2 3 The cause of aphthous ulcers is unknown.

They can make eating very painful, which sometimes causes loss of appetite and weight loss.

Some treatment drugs may also cause ulcers. ddC (zalcitabine, Hivid) has been implicated in oesophageal ulceration.4


  1. Bach MC et al. Odynophagia from aphthous ulcers of the pharynx and esophagus in AIDS. Ann Intern Med 109: 338-339, 1988
  2. Bach MC et al. Aphthous ulceration of the gastro-intestinal tract in patients with AIDS. Ann Intern Med 112: 465-467, 1990
  3. Wilcox CM et al. Esophageal ulceration in human immunodeficiency virus infection. Annals of Internal Medicine 122(2):143-149, 1995
  4. Indorf AS et al. Esophageal ulceration related to zalcitabine (ddC). Ann Intern Med 117: 133-134, 1992