Abstract
Oropharyngeal candidosis (OPC) is an opportunistic fungal infection that is commonly found in HIV-infected patients, even in the twenty-first century. Candida albicans is the main pathogen, but other Candida species have been isolated. OPC usually presents months or years before other severe opportunistic infections and may indicate the presence or progression of HIV disease. The concept of OPC as a biofilm infection has changed our understanding of its pathobiology. Various anti-fungal agents (both topical and systemic) are available to treat OPC. However, anti-fungal resistance as a result of the long-term use of anti-fungal agents and recurrent oropharyngeal infection in AIDS patients require alternative anti-fungal therapies. In addition, both identifying the causative Candida species and conducting anti-fungal vulnerability testing can improve a clinician's ability to prescribe effective anti-fungal agents. The present review focuses on the current findings and therapeutic challenges for HIV-infected patients with OPC.
Highlights
Oropharyngeal candidosis (OPC) is the most prevalent and recurrent opportunistic infection in acquired immune deficiency syndrome (AIDS) patients and often indicates the presence of human immunodeficiency virus (HIV) infection and its progression (Li et al, 2012)
According to Flint et al (2006), OPC meets the criteria to serve as a useful marker for both the restoration of immune functions and HIV disease progression following highly active antiretroviral therapy (HAART) failure, because it is not gender- or race-specific, it occurs early in immune dysfunction in the erythematous form, and its prevalence correlates with the HIV viral load
The occurrence of OPC has declined following the introduction of anti-retroviral therapy (ART), it remains a substantial problem for patients in resource-limited locales or among individuals who develop mycological resistance or have a poor immunologic response (Thompson et al, 2010)
Summary
Oropharyngeal candidosis (OPC) is the most prevalent and recurrent opportunistic infection in acquired immune deficiency syndrome (AIDS) patients and often indicates the presence of human immunodeficiency virus (HIV) infection and its progression (Li et al, 2012). According to Flint et al (2006), OPC meets the criteria to serve as a useful marker for both the restoration of immune functions and HIV disease progression following highly active antiretroviral therapy (HAART) failure, because it is not gender- or race-specific, it occurs early in immune dysfunction in the erythematous form, and its prevalence correlates with the HIV viral load. OPC inevitably occurs in ∼80–90% of HIV patients in the primary, asymptomatic, or overt phases of the disease (Vazquez, 2000). It primarily manifests as a superficial mucosal infection in the form of pseudomembranous, erythematous, or angular cheilitis in HIV-positive individuals
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