Abstract
OBJECTIVESOropharyngeal candidiasis is one of the most common opportunistic fungal infections among human immunodeficiency virus (HIV)-infected individuals. The most common cause is Candida albicans, followed by non-albicans Candida. This study aimed to identify colonized Candida species in HIV-infected patients from Ahvaz, Iran. Additionally, the relationships between immunity-related factors, lifestyle, and colonization of Candida spp. were studied.METHODSOral swabs were taken from 201 HIV-positive patients referred for consultations at the Behavioral Modification Center. Oral Candida colonization was detected using culture-based and molecular assays. Data were assessed by descriptive statistics and analyzed to investigate the correlation between Candida colonization and various factors, including the CD4+ cell count and viral load.RESULTSIt was found that 43.8% of patients were positive for Candida. The most common species was C. albicans (48.0%), followed by non-albicans Candida isolates, including C. dubliniensis, C. glabrata, C. tropicalis, C. parapsilosis, C. guilliermondii, C. kefyr, and C. krusei. Colonization of Candida spp. in patients was associated with a CD4 count ≤200 cells/mm3 (odds ratio [OR], 4.62; p<0.05), history of shared injections (OR, 6.96; p<0.001), and sex (OR, 3.59; p<0.05).CONCLUSIONSThe results of this study showed that C. albicans was the dominant pathogen. The risk factors for colonization of Candida spp. were a CD4 count ≤ 200/mm3 , a history of shared injections, and sex. Other factors with potential relationships include viral load, age, and opportunistic infections, but further investigations are needed.
Highlights
Oropharyngeal candidiasis (OPC) is an opportunistic fungal infection that affects the oral mucosa
The current study aimed to evaluate the colonization of Candida spp. in human immunodeficiency virus (HIV)-positive patients, to determine the distribution of Candida spp., and to identify the relationships of Candida spp. colonization with a CD4 count ≤ 200 cells/mm3, viral load, history of shared injections, sex, age, intravenous drug use, underlying disease, having a safe and secure sexual relationship, the use of antiretroviral medication, and the use of prophylactic medication
HIV patients have a high incidence of Candida colonization and are more susceptible to OPC [14,15]
Summary
Oropharyngeal candidiasis (OPC) is an opportunistic fungal infection that affects the oral mucosa. To treat OPC, it is necessary to identify the causative species because a majority of infections contain mixed Candida spp. Both C. albicans and non-albicans Candida spp. may be affected by acquired and intrinsic antifungal resistance, which could influence the management of the disease and contribute to the spread of candidiasis to esophageal tissue, malnutrition, and interference
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