Risk factors for esophageal candidiasis in a large cohort of HIV-infected patients treated with nucleoside analogues

To assess the risk factors for esophageal candidiasis (EC), a cohort study and a case-control study were conducted using 1,368 French patients who wer e already participating in the Delta trial (which compared different types of antiretroviral therapy in HIV-infected patients) and who had no previous history of EC. During a median follow-up period of 19 months, 87 (6%) pati ents developed EC. The results of the cohort study showed an increased risk of EC associated with a low baseline CD4+ cell count (P <0.0001), a high b aseline plasma HIV RNA level (P <0.0001) and prior zidovudine therapy (P=0. 02) at entry to the study. The case-control study revealed an increased ris k of EC in patients with a recent low CD4+ cell count (P <0.0002), recent a ntibacterial chemotherapy (P=0.01) and oral candidiasis (P <0.05). Cotrimox azole prophylaxis also increased the risk of EC (P=0.04) in the case-contro l study.