Chen Yan-Hua, Jao Tzu-Ming, Shiue Yow-Ling, Feng I-Jung, Hsu Ping-I
Department of Internal Medicine, Kaohsiung Veterans General Hospital Pingtung Branch, Pingtung 91245, Taiwan.
Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 80424, Taiwan.
World J Clin Cases. 2022 Oct 26;10(30):10896-10905. doi: 10.12998/wjcc.v10.i30.10896.
esophagitis (CE) is among the commonest esophageal infections and is known as an opportunistic fungal infection mostly affecting people living with the human immunodeficiency virus (HIV). However, some medical conditions might predispose HIV-negative individuals to esophageal candidiasis. The epidemiology and associated endoscopic findings of CE among people without HIV have rarely been reported.
To investigate the prevalence of CE among HIV-negative persons, and determine risk factors predicting CE.
Between January 2015 and December 2018, all consecutive outpatients who underwent routine esophagogastroduodenoscopy as part of health check-ups at their own expense at the Health Check-up Center of the Kaohsiung Veterans General Hospital, Taiwan, were recruited in this study. Those with positive HIV serology results were excluded. Sociodemographic and clinical characteristics including age, gender, economic status, smoking history, alcohol consumption, tea and coffee consumption, underlying diseases, body fat percentage, body mass index, endoscopic findings, and infection status were carefully reviewed. CE was confirmed by endoscopic biopsy and pathological assessment with hematoxylin and eosin and periodic acid-Schiff staining. To evaluate independent factors predicting the development of CE, we conducted a univariate analysis of clinical characteristics. The variables found to be significant univariate analysis were subsequently included in a multivariable analysis of potential risk factors for CE development.
A total of 11802 participants were included in this study. Forty-seven (0.4%) were confirmed as having CE by pathological examination. Univariate analysis identified older age, the presence of chronic kidney disease, alcohol consumption, and steroid use ( = 0.023, < 0.001, 0.033, and 0.004, respectively) as significantly associated with CE. Multivariable analysis revealed older age [adjusted odds ratio (OR) = 1.027; 95%CI: 1.001-1.053; = 0.045], chronic kidney disease (adjusted OR = 13.470; 95%CI: 4.574-39.673; < 0.001), alcohol consumption (adjusted OR = 2.103; 95%CI: 1.151-3.844; = 0.016), and steroid use (adjusted OR = 24.255; 95%CI: 5.343-110.115; < 0.001) as independent risk factors for CE development. The presence of dysphagia was associated with severe CE ( = 0.021).
The prevalence of CE among HIV-negative persons was 0.4% in Taiwan. Independent risk factors for CE were older age, chronic kidney disease, alcohol consumption, and steroid use.
念珠菌性食管炎（CE）是最常见的食管感染之一，是一种机会性真菌感染，主要影响人类免疫缺陷病毒（HIV）感染者。然而，一些医疗状况可能使HIV阴性个体易患食管念珠菌病。关于无HIV人群中CE的流行病学及相关内镜检查结果鲜有报道。
调查HIV阴性人群中CE的患病率，并确定预测CE的危险因素。
2015年1月至2018年12月，在台湾高雄荣民总医院健康检查中心自费进行常规食管胃十二指肠镜检查作为健康体检一部分的所有连续门诊患者纳入本研究。HIV血清学结果阳性者被排除。仔细回顾社会人口统计学和临床特征，包括年龄、性别、经济状况、吸烟史、饮酒情况、茶和咖啡饮用情况、基础疾病、体脂百分比、体重指数、内镜检查结果及感染状况。通过内镜活检及苏木精-伊红染色和过碘酸-希夫染色的病理评估确诊CE。为评估预测CE发生的独立因素，我们对临床特征进行单因素分析。单因素分析中发现有意义的变量随后纳入CE发生潜在危险因素的多因素分析。
本研究共纳入11802名参与者。47例（0.4%）经病理检查确诊为CE。单因素分析确定年龄较大、存在慢性肾脏病、饮酒及使用类固醇（分别为P = 0.023、P < 0.001、P = 0.033和P = 0.004）与CE显著相关。多因素分析显示年龄较大（调整优势比[OR] = 1.027；95%置信区间[CI]：1.001 - 1.053；P = 0.045）、慢性肾脏病（调整OR = 13.470；95%CI：4.574 - 39.673；P < 0.001）、饮酒（调整OR = 2.103；95%CI：1.151 - 3.844；P = 0.016）及使用类固醇（调整OR = 24.255；95%CI：5.343 - 110.115；P < 0.001）是CE发生的独立危险因素。吞咽困难的存在与严重CE相关（P = 0.021）。
台湾HIV阴性人群中CE的患病率为0.4%。CE的独立危险因素为年龄较大、慢性肾脏病、饮酒及使用类固醇。
