Liver cirrhosis as a predisposing risk factor for esophageal candidiasis: Bystander or culprit?

摘要

Candida esophagitis is the most common infectious disease of the esophagus and the most common gastrointestinal opportunistic disorder among individuals infected with human immunodeficiency virus (HIV). Ou et al [1] conducted a study using a retrospective chart review of non-HIV-infected patients with esophageal candidiasis and particularly aimed to elucidate the role of liver cirrhosis in esophageal candidiasis. I have long thought that retrospective chart reviews are usually poorly done and are subject to all sorts of biases and confounding issues. The editorial allowed me to review the article presented by Ou et al [1] and feel that it shared many of these problems. Actually, most of the clinical relevant data of esophageal candidiasis were gathered from HIV-infected patients. Fungal infections have not been adequately studied in patients with liver cirrhosis [2]. The main interest had been focused on acute liver failure and liver transplantation [3,4]. The current study is a unique one to focus on esophageal candidiasis in patients with liver cirrhosis thus far and did identify discussion-worthy issues regarding specific risks in cirrhotic patients.