Esophageal candidiasis remains one of the most common AIDS defining illnesses in patients with human immunodeficiency virus (HIV) on highly active antiretroviral therapy.
Little is known about factors associated with esophageal candidiasis after starting highly active antiretroviral therapy.
Dr Amanda Mocroft and colleagues described changes in the use of antimycotic medication.
|There was a 32% annual decline in the incidence of esophageal candidiasis|
|American Journal of Gastroenterology|
The research team also described changes in the incidence of esophageal candidiasis.
In addition, the team assessed factors associated with esophageal candidiasis before and after starting highly active antiretroviral therapy.
The team included patients from EuroSIDA, a pan-European longitudinal, prospective observational study.
Generalized linear models and poisson regression models were used to investigate the relationships.
The researchers found that a total of 9873 patients did not have esophageal candidiasis at recruitment, however 537 developed esophageal candidiasis .
The proportion of patients taking any antimycotic dropped from 18% in 1995 to 2% in 2004.
The researchers observed that the duration of treatment declined from 10 to 3 months over the same period.
The research team noted a 32% annual decline in the incidence of esophageal candidiasis.
Using time-updated adjusted models, the team observed an annual decline in esophageal candidiasis pre-highly active antiretroviral therapy, but not post- highly active antiretroviral therapy.
Older patients and those with low CD4 counts had the greatest incidence of esophageal candidiasis in the post- highly active antiretroviral therapy era.
Dr Macroft and team conclude, “There has been a marked decline in the incidence of esophageal candidiasis between 1994 and 2004.”
“This was accompanied by a decline in markers associated with fungal disease, including use of antimycotics and a decline in duration of treatment.”