Diversity and clinical presentation of Candida species in human immunodeficiency virus patients with oral candidiasis

• Published in: Saudi Journal of Oral Sciences Vol. 6; no. 2; pp. 96 - 100
• Main Authors: Nair, Varun, Shetti, Arvind
• Format: Journal Article
• Language: English
• Published: Medknow Publications and Media Pvt. Ltd 01.07.2019; Wolters Kluwer Medknow Publications
• Subjects: Antifungal agents; Antiretroviral therapy; Candidiasis; CD4 count; HIV; HIV patients; human immunodeficiency virus; Immunotherapy; Mycoses; Oral candidiasis; pseudomembranous candidiasis
• ISSN: 1658-6816
• DOI: 10.4103/sjos.SJOralSci_74_18

Background: Change in the distribution profile of nonalbicans Candida species (spp.) can be an indication of immunosuppression or drug resistance to oral candidiasis in patients with human immunodeficiency virus (HIV). Thus, it is essential to analyze the association of the profile of varied Candida spp. Objective: The study aimed to collect the baseline data of diversity in the Candida spp. in HIV patients with oral candidiasis and correlate it with clinical presentations. Materials and Methods: A total of 200 HIV patients with CD4 count <200 cells/μL were included in the study. A presumptive diagnosis of oral candidiasis was made, and different clinical forms of candidiasis were recorded. The oral swab samples collected from the patients were sent to the microbiological laboratory for culture. Different Candida spp. were isolated, and an association was analyzed with various variables, including clinical presentation, CD4 count, and duration of antiretroviral therapy (ART). A correlation between CD4 count and ART duration was also assessed. Results: Pseudomembranous candidiasis was the most (46.50%) prevalent type identified in HIV patients. Candida albicans was the most prevalent (68%) spp. in HIV patients. Clinical form of candidiasis was significantly associated with isolated spp. (P < 0.00001). CD4 counts (P < 0.001) and ART (P = 0.03) duration significantly differed among clinical forms of candidiasis. ART duration was significantly correlated with CD4 count (r = 0.18; P = 0.01). Conclusion: The study suggests the significance of various Candida spp. in the prediction of disease progression and immune suppression levels in HIV-infected oral candidiasis patients. Intensifying the concentration of nonalbicans spp. isolated in these studies predicts the change in immune status.