Characteristic clinical manifestations of oropharyngeal candidiasis in patients with the late stages of HIV infection

Abstract

Oropharyngeal candidiasis (OPC) is the most common opportunistic disease in HIV infection. Material and methods. The authors examined 512 patients (311 male and 201 female patients) aged 18 to 52 years, with the stage 4 of HIV infection. Conclusion. Acute candidiasis was diagnosed in the first group patients (HIV infection, stage 4A), while chronic forms of fungal infection were absent. No signs of mycotic lesions of the tonsils and mucosa of the posterior pharyngeal wall were revealed. In the second group (HIV infection, stage 4B) fungal process was more common than in patients with stage 4A, both acute and chronic forms of OPC were observed. The authors revealed five different two- and three-component combinations of OPC forms, which had not been observed in the patients with stage 4A. The proportion of patients with the stage 4B in all the observed cases of the three-component combined lesion was 14.5±4.4%. The average number of CD4+ T-lymphocytes in the patients of the third group with the stage 4C of HIV infection was 57±2 cells per μl of blood. Severe xerostomia was observed. The combinations of OPC chronic clinical forms prevailed (83.5±2.5%). Chronic OPC forms prevailed in patients with 4B stage of HIV infection. Chronic pseudomembranous candidiasis was diagnosed in 89.5±2.4% of patients. 67.9±8.2% of cases had chronic hyperplastic candidiasis both in the form of a solitary lesion and as part of a combination. Fungal infection of the mucous membrane had multilocal nature with the involvement of the palatine arches, palatine tonsils, posterior pharyngeal wall. All cases of the total mucous membrane lesion of the oral cavity and pharynx were observed in patients with stage 4C of the disease.