Levels of salivary IgA antibodies to Candida spp. in HIV-infected adult patients: A systematic review

Abstract

Objective To perform a systematic review of published data with the aim of evaluating the levels of IgA antibodies to Candida albicans in HIV-infected adult patients. Methods The search strategy was based on PubMed, Web of Science, Google Scholar, Cochrane and EMBASE databases. Also, the reference lists of included studies were searched. All abstracts found by electronic searches were independently scrutinized by two reviewers. To be eligible for review, the controlled studies had to present the following characteristics: samples of both HIV-infected adults and noninfected adults; appropriate HIV-diagnostic tests for both patient groups (case and control); IgA-diagnostic test applied to a similar population sample. Results Of 144 studies found, only six met the initial eligibility criteria, but three were excluded after a thorough analysis. To assess the methodological quality of the three remaining studies, they were categorized according the risk of bias. The three selected studies revealed that the levels of C. albicans-specific IgA antibody were higher in HIV-infected individuals compared with the control group. Conclusion Adequate IgA antibody responses to C. albicans appear to be maintained, since the levels of these antibodies were higher in all studies selected. Although the findings of this systematic review are encouraging, the scientific evidence should be interpreted carefully because there are only a few reports in the literature, mostly because of the lack of important methodological details or the varying methodologies employed.