Anti-retroviral therapy with protease inhibitors decreases virulence enzyme expression in vivo by Candida albicans without selection of avirulent fungus strains or decreasing their anti-mycotic susceptibility

• Published in: FEMS immunology and medical microbiology Vol. 41; no. 1; pp. 27 - 34
• Main Authors: De Bernardis, Flavia, Tacconelli, Evelina, Mondello, Francesca, Cataldo, Adriana, Arancia, Silvia, Cauda, Roberto, Cassone, Antonio
• Format: Journal Article
• Language: English
• Published: Oxford, UK Elsevier B.V 01.05.2004; Blackwell Publishing Ltd; Blackwell; Oxford University Press
• Subjects: Adult; AIDS-Related Opportunistic Infections - drug therapy; Antiretroviral drugs; Antiretroviral Therapy, Highly Active; Aspartic Acid Endopeptidases - metabolism; Biological and medical sciences; Biotypes; Candida; Candida - drug effects; Candida - enzymology; Candida - isolation & purification; Candida - pathogenicity; Candida albicans; Candidiasis, Oral - drug therapy; Cross-Sectional Studies; Female; Fundamental and applied biological sciences. Psychology; Fungi; Highly active antiretroviral therapy; HIV; HIV Infections - drug therapy; HIV Infections - immunology; HIV Protease Inhibitors - therapeutic use; Human immunodeficiency virus; Humans; Longitudinal Studies; Male; Microbiology; Miscellaneous; Mycology; Oral cavity; Oropharynx - microbiology; Protease; Protease inhibitors; Proteinase; Proteinase inhibitors; Proteinase secretion; Reverse Transcriptase Inhibitors - therapeutic use; Saliva - microbiology; Virulence; Viruses; Biotypes; Proteinase secretion; Proteinase inhibitors; HIV; Candida; Candida albicans; Yeast; Microbiology; Enzyme; Virulence; Enzyme inhibitor; Fungi; Avirulent strain; Sensitivity; Immunology; Treatment; Antiviral; Fungi Imperfecti; Protease inhibitor; Thallophyta
• ISSN: 0928-8244; 1574-695X; 2049-632X
• DOI: 10.1016/j.femsim.2003.12.006

Highly active anti-retroviral therapies (HAART) with human immunodeficiency virus (HIV) protease inhibitors (PIs) or nonnucleoside reverse-transcriptase inhibitors (NNRTI) were compared for their effect on prevalence, aspartyl proteinase (Sap) production and the biotypes and anti-mycotic sequential susceptibility of Candida spp. isolates from the oral cavity in a longitudinal prospective study. HAART-PI, but not HAART-NNRTI strongly inhibited Sap expression in the oral cavity without exerting any consistent effect on the role of Candida spp. isolation or selection of low virulence or anti-mycotic resistant fungus biotype. More importantly, the sequential isolates of Candida albicans from HAART-PI, but not those from suspended HAART-NNRTI, showed an increased Sap production in vitro. While further demonstrating that HIV-PI inhibit Sap expressions, our results do not support the view that the mentioned inhibition could eliminate Candida or its selection of the oral cavity.