Prevalence and clinical risk factors for esophageal candidiasis in non-human immunodeficiency virus patients: A multicenter retrospective case-control study

Table 1 Study population and comparison of patients with and without esophageal candidiasis, n (%)

Risk factor	EC1 patients,n = 177	Matched controls, n = 247	P value
Age (yr)	65.00	63.17	0.637
BMI1 (kg/m2)	24.48	26.29	0.003
Gender			0.564
Female	91 (51.40)	134 (54.30)
Male	86 (48.60)	113 (45.70)
Race and ethnicity			0.104
White	74 (41.80)	127 (51.40)
Black	90 (50.80)	109 (44.10)
Other1	13 (7.30)	11 (4.50)
Heavy alcohol use	16 (9.00)	42 (17.00)	0.019
Tobacco use	97 (54.80)	123 (49.80)	0.309
GERD1	71 (40.10)	68 (27.50)	0.006
Diabetes	63 (35.60)	71 (28.70)	0.135
Liver cirrhosis	9 (5.10)	7 (2.80)	0.23
End stage renal disease	24 (13.60)	26 (10.60)	0.347
Transplant recipient	19 (10.70)	5 (2.00)	< 0.001
Active Malignancy	32 (18.10)	32 (13.00)	0.146
Immunosuppressive medication use1	32 (18.10)	20 (8.10)	0.002
TNF inhibitor use1	1 (0.60)	1 (0.40)	0.812
Proton pump inhibitor use	85 (48.00)	74 (30.00)	< 0.001
H2RA use	21 (11.90)	30 (12.10)	0.93
Corticosteroid use	62 (35.00)	42 (17.00)	< 0.001
Tylenol use	45 (25.40)	40 (16.20)	0.019
NSAID use1	18 (10.20)	21 (8.50)	0.558
Aspirin use	69 (39.00)	68 (27.50)	0.013
Bisphosphonate use	3 (1.70)	2 (0.80)	0.405
Antibiotic use	22 (12.40)	19 (7.70)	0.104

¹Immunosuppressive medication includes chemotherapy, immunomodulator, calcineurin inhibitors, or biological therapies. EC: Esophageal candidiasis; BMI: Body mass index; Race and ethnicity other subcategory, includes Hispanic, Latine, Asian and not identified; GERD: Gastroesophageal reflux disease; TNF: Tumor necrosis alpha; H2RA: Histamine type-2 receptor antagonist; NSAID: Non-steroidal anti-inflammatory.

Table 2 Comparison of presenting symptoms in patients with and without esophageal candidiasis, n (%)

Presenting symptom	EC1 patients, n = 177	Matched controls, n = 247
Dysphagia	52 (16.94)	52 (11.95)
Nausea	46 (14.98)	76 (17.47)
Melena	45 (14.66)	58 (13.33)
Vomiting	42 (13.68)	79 (18.16)
Hematemesis	26 (8.47)	44 (10.11)
Epigastric pain	21 (6.84)	22 (5.06)
Weight loss	18 (5.86)	8 (1.84)
Non-specific	17 (5.54)	36 (8.28)
Abdominal pain
Diarrhea	13 (4.23)	7 (1.61)
Chest pain	12 (3.91)	18 (4.14)
Asymptomatic	11 (3.58)	11 (2.53)
Odynophagia	10 (3.26)	11 (2.53)
Dyspepsia	6 (1.95)	9 (2.07)
Acid reflux	5 (1.63)	2 (0.46)
Unknown	0 (0.00)	2 (0.46)

¹EC: Esophageal candidiasis; Unknown: presence or absence of symptoms not reported.

Table 3 Multivariate analysis of risk factors for esophageal candidiasis

Risk factor	Odds ratio	P value
Gender
Female	Reference
Male	1.28	0.269
Race and ethnicity
White	Reference
Black	1.50	0.080
Other1	2.55	0.041
Age	1.00	0.720
BMI1	0.99	0.209
Heavy alcohol use	0.51	0.059
GERD1	1.60	0.051
Transplant recipient	5.81	0.009
Immunosuppressive medication use1	0.87	0.746
Proton pump inhibitor use	1.66	0.030
Corticosteroid use	2.05	0.007
Tylenol use	1.57	0.092
Aspirin use	1.45	0.115

¹Immunosuppressive medication defined as chemotherapy, immunomodulator, calcineurin inhibitors, or biological therapies. BMI: Body mass index; Race and ethnicity other subcategory, includes Hispanic, Latine, Asian and not identified; GERD: Gastroesophageal reflux disease.