TY - JOUR
T1 - Association of Eosinophilic Esophagitis and Human Immunodeficiency Virus
AU - Asfari, Mohammad Maysara
AU - Kendrick, Katherine
AU - Sarmini, Muhammad Talal
AU - Uy, Pearl
AU - Vega, Kenneth J.
N1 - Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2021/8
Y1 - 2021/8
N2 - Background: Eosinophilic esophagitis (EoE) is thought to be an atopic disorder causing dysphagia. HIV patients have dysphagia from both common (reflux esophagitis) and uncommon causes (idiopathic esophageal ulceration). Only a single case report about the occurrence of EoE in an HIV patient exists in literature. Aim: The aim of this study was to determine if HIV and EoE occur concurrently using a large inpatient database. Methods: Data on hospital admissions of all HIV adult patients were extracted from the 2002–2014 National Inpatient Sample. Comorbidities and outcomes of interest were defined by querying all diagnostic and procedural fields for the corresponding ICD-9 codes. Univariable and multivariable logistic regression analysis was performed to assess the association between HIV and EoE. Similarly, we assessed the relation between HIV and eosinophilic gastroenteritis (EGE). Results: The total population comprised of 101,137,145 patients, of which 231,691 (0.229%) have HIV and 5038 (0.004%) have EoE. HIV patients were younger (45.2 vs 48 years old and more likely to be male (62.2% vs 41.5%) and African American (53.9% vs 14.2%) compared to non-HIV patients (P < 0.001 for all). After adjusting for potential cofounding factors, HIV patients had a statistically significant higher rate of EoE (Odds Ratio 2.108, with 95% confidence interval 1.268-3.506, P = 0.004) compared to the non-HIV group. On the other hand, HIV was not associated with increased risk of EGE (Odds Ratio 0.78, 95% confidence interval 0.109-5.557, P = 0.804). Conclusion: Patients with HIV are twice as likely to have EoE compared to those without HIV. Evaluation of dysphagia in HIV patients should include assessment for EoE, especially when empiric antifungal therapy for candida esophagitis does not improve clinical symptoms.
AB - Background: Eosinophilic esophagitis (EoE) is thought to be an atopic disorder causing dysphagia. HIV patients have dysphagia from both common (reflux esophagitis) and uncommon causes (idiopathic esophageal ulceration). Only a single case report about the occurrence of EoE in an HIV patient exists in literature. Aim: The aim of this study was to determine if HIV and EoE occur concurrently using a large inpatient database. Methods: Data on hospital admissions of all HIV adult patients were extracted from the 2002–2014 National Inpatient Sample. Comorbidities and outcomes of interest were defined by querying all diagnostic and procedural fields for the corresponding ICD-9 codes. Univariable and multivariable logistic regression analysis was performed to assess the association between HIV and EoE. Similarly, we assessed the relation between HIV and eosinophilic gastroenteritis (EGE). Results: The total population comprised of 101,137,145 patients, of which 231,691 (0.229%) have HIV and 5038 (0.004%) have EoE. HIV patients were younger (45.2 vs 48 years old and more likely to be male (62.2% vs 41.5%) and African American (53.9% vs 14.2%) compared to non-HIV patients (P < 0.001 for all). After adjusting for potential cofounding factors, HIV patients had a statistically significant higher rate of EoE (Odds Ratio 2.108, with 95% confidence interval 1.268-3.506, P = 0.004) compared to the non-HIV group. On the other hand, HIV was not associated with increased risk of EGE (Odds Ratio 0.78, 95% confidence interval 0.109-5.557, P = 0.804). Conclusion: Patients with HIV are twice as likely to have EoE compared to those without HIV. Evaluation of dysphagia in HIV patients should include assessment for EoE, especially when empiric antifungal therapy for candida esophagitis does not improve clinical symptoms.
KW - Dysphagia
KW - Eosinophilic esophagitis
KW - Human immunodeficiency virus
UR - http://www.scopus.com/inward/record.url?scp=85089856862&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089856862&partnerID=8YFLogxK
U2 - 10.1007/s10620-020-06566-y
DO - 10.1007/s10620-020-06566-y
M3 - Article
C2 - 32851497
AN - SCOPUS:85089856862
SN - 0163-2116
VL - 66
SP - 2669
EP - 2673
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 8
ER -