EoE ToT Module 6 References-Ou et al Adv Dig Med 2014 Liver cirrhosis as a predisposing factor for esophageal candidiasis

Ou et al Adv Dig Med 2014 Liver cirrhosis as a predisposing factor for esophageal candidiasis

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The article explores the relationship between liver cirrhosis and esophageal candidiasis (EC), a fungal infection typically associated with immunocompromised conditions like HIV. It highlights a study conducted at Tri-Service General Hospital in Taiwan, examining non-HIV-infected patients treated between 2009 and 2012. The key findings suggest that liver cirrhosis significantly increases the risk of EC compared to non-cirrhotic patients, with an incidence rate of 0.8% in cirrhotic patients versus 0.36% in non-cirrhotic patients (relative risk 2.2, p < 0.001).<br /><br />The study analyzed 43,217 non-HIV-infected patients, of whom 3017 had liver cirrhosis. Multivariate logistic regression identified liver cirrhosis as an independent risk factor for EC with an odds ratio of 1.74 (95% CI, 1.06-2.87; p = 0.029). Notably, cirrhotic patients with EC were more likely to be asymptomatic (45.8% vs. 9% in non-cirrhotic patients, p = 0.01) and commonly presented with coexisting conditions like reflux esophagitis (83.9%).<br /><br />Despite antifungal treatment, the study found no significant difference in mortality rates during hospitalization for cirrhotic versus non-cirrhotic patients. The article emphasizes the need for further prospective studies to confirm these findings.<br /><br />In summary, liver cirrhosis was identified as a significant independent risk factor for EC, with cirrhotic patients likely to be asymptomatic. The study suggests reconsideration of diagnostic and treatment approaches for EC in cirrhotic patients, as current antifungal treatments did not significantly improve patient outcomes.

Keywords

liver cirrhosis

esophageal candidiasis

immunocompromised conditions

HIV

Tri-Service General Hospital

non-HIV-infected patients

risk factor

antifungal treatment

mortality rates