RRC ID 47002
Author Delgado AC, de Jesus Pedro R, Aoki FH, Resende MR, Trabasso P, Colombo AL, de Oliveira MS, Mikami Y, Moretti ML.
Title Clinical and microbiological assessment of patients with a long-term diagnosis of human immunodeficiency virus infection and Candida oral colonization.
Journal Clin Microbiol Infect
Abstract The objective of this study was to evaluate Candida oral colonization in human immunodeficiency virus (HIV)-infected patients undergoing long-term highly active antiretroviral therapy (ARV). The cross-sectional study included 331 HIV patients, diagnosed from 1983 to 2003. Oral swabs were performed, and Candida species were determined using ID 32C. Isolates were tested for antifungal susceptibility. Clinical and laboratory data were collected to identify the association with Candida colonization. In total, 161 Candida isolates were detected among 147 of the 331 patients (44%), independently of the time when HIV infection was diagnosed. Candida albicans strains represented 137 (85%) of the isolates, and were susceptible to all of the tested antifungal drugs. Among the non-C. albicans strains, six isolates were dose-dependently susceptible to fluconazole, nine to itraconazole, and seven to ketoconazole. The isolation of Candida was significantly higher in patients with virological failure (83/147; p 0.0002) and CD4(+) T-lymphocyte counts <200 cells/mm(3) (30/83; p 0.0003). Recovery of Candida in the oral cavity was independent of protease inhibitor (PI) usage (p 0.60). Colonized patients typically underwent salvage therapy (p 0.003), and had more episodes of opportunistic fungal infections (p 0.046) and malignancies (p 0.004).Oral Candida colonization in patients under ARV therapy was associated with the immunosupressed status of HIV-infected patients, i.e. low number of CD4(+) T-cells per cubic millimetre, failure of ARV therapy (salvage therapy), and higher number of opportunistic infections and malignancies. Despite the fact that PIs have in vitro antifungal activity, the use of this class of antiretroviral agent did not influence the presence of Candida in the oral cavity of AIDS patients.
Volume 15(4)
Pages 364-71
Published 2009-4-1
DOI 10.1111/j.1469-0691.2009.02707.x
PII S1198-743X(14)60398-0
PMID 19431223
MeSH Adult Anti-HIV Agents / therapeutic use Antifungal Agents / pharmacology Antiretroviral Therapy, Highly Active CD4 Lymphocyte Count Candida / classification Candida / drug effects Candida / isolation & purification Candidiasis, Oral / epidemiology* Candidiasis, Oral / microbiology* Candidiasis, Oral / pathology Cross-Sectional Studies Female HIV / isolation & purification HIV Infections / complications* HIV Infections / drug therapy HIV Infections / pathology HIV Infections / virology* Humans Immunocompromised Host Male Microbial Sensitivity Tests Neoplasms / epidemiology Salvage Therapy Treatment Failure Viral Load
IF 7.117
Times Cited 32
Pathogenic microorganisms