Spectrum of invasive candidiasis in correlation with CD4+ T lymphocyte count along with antifungal susceptibility pattern of isolates from PLHA patients recruited at a tertiary care hospital in Odisha

Abstract

Introduction: Invasive candidiasis is considered as one of the major opportunistic fungal infections in PLHA patients causing significant morbidity and mortality in these patients with low CD4 cell count. This study was conducted to isolate and identify the various Candida species involved in invasive infections with their antifungal susceptibility pattern and to establish a correlation of opportunistic clinical presentations with patient immune status defined by CD4 cell count. Materials and Methods: This prospective study included 231 HIV positive adult (>18yrs) patients with clinically suspected invasive fungal infections with CD4 cell count Results: Majority of patients in the study group were males in age group of 26-30yrs. Most of the invasive fungal infections in HIV positive patients were established to be Candidiasis among which oropharyngeal candidiasis followed by pneumonia were the most common clinical presentations. Most of the patients suffering from candidiasis belong to CD4 cell count ranging between 100-200cells/?l. Candida albicans followed by Candida tropicalis were the common isolates which were highly sensitive to Voriconazole and most resistant to Fluconazole. Conclusion: A detailed understanding of epidemiology, immune status and antifungal sensitivities among HIV positive patients suffering from invasive candidiasis can alert the clinicians and help in timely diagnosis with appropriate treatment. Keywords: PLHA (People living with HIV/AIDS), Opportunistic infections, Invasive candidiasis, CD4 cell count, Candida species, Antifungal susceptibility pattern.