Long-Term Trends in Esophageal Candidiasis Prevalence and Associated Risk Factors with or without HIV Infection: Lessons from an Endoscopic Study of 80,219 Patients

摘要: Background The prevalence of candida esophagitis (CE) might be changing in an era highly active antiretroviral therapy (HAART) among HIV-infected patients or today’s rapidly aging society non-HIV-infected patients. However, few studies have investigated long-term CE trends, and risk factors not been studied a large sample, case-control study. This study aimed to determine trends associated for with without HIV infection. Methods Trends were explored cohort 80,219 who underwent endoscopy between 2002 2014. Risks examined subcohort 6,011 patients. In analysis, we assessed lifestyles, infections, co-morbidities, immunosuppressants, proton-pump inhibitors (PPIs). All tested HIV, hepatitis B C virus, syphilis infection. For patients, sexual behavior, CD4 cell count, history HAART also assessed. Results CE was 1.7% (1,375/80,219) in all 9.8% (156/1,595) in 1.6% (1,219/78,624) from 2002-2003 2012-2014 tended increase (0.6% 2.5%; P<0.01) decrease patients (13.6% 9.0%; P=0.097). Multivariate analysis revealed increasing age (odds ratio [OR], 1.02; p=0.007), infection (OR, 4.92; p<0.001), corticosteroid use 5.90; p<0.001) significantly CE, smoking 1.32; p=0.085) acetaminophen 1.70; p=0.097) marginally associated. No significant association was found alcohol consumption, syphilis, diabetes mellitus, cardiovascular disease, cerebrovascular chronic kidney liver cirrhosis, anticancer, PPIs use. In count <100/μL 4.83; prior HAART 0.35; p=0.006) independently but behavior not. Among users, higher prednisone-equivalent dose (p=0.043 trend test). Conclusions This large, endoscopy-based demonstrated that increased decreased over 13 years. Risk age, infection, corticosteroids use, particularly at doses, alcohol, other diabetes, anticancer drugs, PPIs use