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Decline in Esophageal Candidiasis and Use
of Antimycotics in European HIV Patients
Esophageal
candidiasis (EC)
remains one of the most common AIDS-defining
illnesses
in patients with HIV in the era of HAART, but little is known about
factors associated with EC after starting HAART.
The aim of the current
study was to describe changes in the use of antimycotic medication,
the incidence of EC and factors associated with EC before and after
starting HAART.
Patients from EuroSIDA,
a pan-European longitudinal, prospective observational study, were
followed retrospectively. Generalized linear models and poisson
regression models were used to investigate the relationships.
Results
· A
total of 9,873 patients did not have EC at recruitment, subsequently
537 (15.8%) developed EC.
· The
proportion of patients taking any antimycotic dropped from 18% at
January 1995 to 2% at January 2004 (p< 0.0001); the duration
of treatment declined from 10 to 3 months over the same period (p<
0.0001).
· There
was a 32% annual decline in the incidence of EC (95% CI 30 35%, p<
0.0001).
· There was a significant annual decline in the incidence
of EC pre-HAART in time-updated, adjusted models.
· Older
patients and those with low CD4 counts had the greatest incidence
of EC in the post-HAART era.
Conclusions
The
authors conclude, “There has been a marked decline in the incidence
of EC 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.”
07/06/05
Reference
A
Mocroft and others (for the EuroSIDA Group). Decline in Esophageal Candidiasis and Use of Antimycotics
in European Patients with HIV.
The American Journal of Gastroenterology
100(7):
1446-1454. July 2005.
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