Esophageal Mycoses in HIV-Immunocompetent Subjects and Risk Factors for Occurrence

Abstract

Purpose: To determine the prevalence and risk factors for the occurrence of esophageal mycosis in HIV negative subjects. Methodology: This is a prospective, descriptive and analytical cross-sectional study over seven months from March 1 to October 1, 2022, carried out in the endoscopy unit of the Hepato-Gastroenterology department of the Cocody University Hospital. Included were all patients in whom esogastroduodenal endoscopy (EOGD) (found esophageal mycosis and whose HIV serology was negative. Excluded were HIV positive patients and patients who refused to have HIV serology performed. Re sults: Out of 1588 EOGD performed during the study period, 76 cases of esophageal mycosis with negative HIV serology were identified, giving an endoscopic prevalence of 4.8%. The average age of our patients was 45 years. There was a male predominance with a sex ratio of 1.5. The main defects found were cirrhosis (21.05%), obesity (18.42%), cancer (11.84%), and diabetes (9.21%). The main clinical signs were epigastralgia (60.53%), vomiting (31.58%) and regurgitation (26.32%). Esophageal mycosis without esophagitis was the most common endoscopic finding in 76% of cases. 25% of patients consumed alcohol. African pharmacopoeia was the most commonly used treatment with 55.26% followed by PPIs 34.21%. The main clinical signs were epigastralgia (60.53%), vomiting (31.58%) and regurgitation (26.32%). Esophageal mycosis without esophagitis was the most common endoscopic finding (76%). 46.05% of patients had associated erythematous and/or erosive and/or congestive gastropathy. In univariate analysis, there was no statistically significant association between esophageal mycosis and age (p = 0.46), sex (p = 0.52) and alcohol consumption (p = 0.74). African pharmacopoeia (p = 0.002), Proton Pump Inhibitors (p = 0.0002), cirrhosis (p = 0.02), cancer (p = 0.027) and obesity (p = 0.0002) were statistically significant risk factors for the occurrence of esophageal mycosis. Conclusion: The risk factors implicated in the occurrence of esophageal mycosis in HIV negative subjects were the use of proton pump inhibitors, African pharmacopoeia and conditions such as cirrhosis, obesity or cancer.