Candida oesophagitis is an acquired immune deficiency syndrome (AIDS)-defining illness. We report a 28-year-old woman who presented with Candida oesophagitis with underlying chronic hepatitis C. The patient presented with anorexia and weakness and was noted to have raised serum transaminases. Upper-gastrointestinal endoscopy revealed Candida oesophagitis involving the whole oesophagus. Oesophageal biopsy demonstrated changes consistent with Candida oesophagitis. Serology was positive for hepatitis C antibodies, and polymerase chain reaction (PCR) genotyped hepatitis C virus (HCV) as genotype 3. Liver biopsy revealed chronic hepatitis with moderately active portal inflammation. A human immunodeficiency virus (HIV) test was non-reactive for types 1 and 2. The development of Candida oesophagitis in a patient with chronic HCV infection demands prompt consideration of general debility and immunosuppression as effects of HCV that led to an occurrence of opportunistic infection. Evaluation of this case provides insight into various mechanisms of immune suppression associated with HCV infection.
Section of Gastroenterology, Departments of aMedicine and bPathology, Aga Khan University Hospital, Karachi, Pakistan.
Correspondence to Dr Javed Yakoob MBBS, PhD, Research Fellow, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, National Stadium Road, Karachi, Pakistan. Tel: +92 21 4859 4661; fax: +92 21 493 4294; e-mail: firstname.lastname@example.org
Received 23 September 2002 Revised 26 November 2002 Accepted 15 January 2003