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AIDS Res Treat. 2012; 2012: 262471.
Published online Aug 28, 2012. doi:  10.1155/2012/262471
PMCID: PMC3434376
The Changing Epidemiology of Oropharyngeal Candidiasis in Patients with HIV/AIDS in the Era of Antiretroviral Therapy
Payal K. Patel, 1 , 2 , 3 * Joshua E. Erlandsen, 3 William R. Kirkpatrick, 2 , 3 Deborah K. Berg, 2 , 3 Steven D. Westbrook, 2 , 4 Christopher Louden, 5 John E. Cornell, 5 George R. Thompson, 6 Ana C. Vallor, 7 Brian L. Wickes, 8 Nathan P. Wiederhold, 3 Spencer W. Redding, 2 , 4 and Thomas F. Patterson 2 , 3
1Department of Internal Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA
2South Texas Veterans Health Care System, San Antonio, TX 78229, USA
3Division of Infectious Diseases, The University of Texas Health Science Center at San Antonio, Department of Medicine, 7703 Floyd Curl Drive, MSC 7881, San Antonio, TX 78229-3900, USA
4Department of Comprehensive Dentistry, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA
5Department of Epidemiology & Biostatistics, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA
6Department of Internal Medicine, University of California at Davis School of Medicine, Davis, CA 95817, USA
7University of Incarnate Word, San Antonio, TX 78209, USA
8Department of Microbiology and Immunology, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA
*Payal K. Patel: patelp6/at/uthscsa.edu
Academic Editor: Robert S. Hogg
Received April 25, 2012; Accepted July 14, 2012.
Abstract
The impact of antiretroviral therapy (ART) on opportunistic conditions in HIV patients continues to evolve. We specifically studied the changing epidemiology of oropharyngeal candidiasis (OPC) in 215 HIV/AIDS patients. Status of yeast colonization was assessed from oral rinse samples, and preliminary yeast identification was made using CHROMagar Candida and confirmed with standard microbiological techniques and/or molecular sequencing. Susceptibility to fluconazole was determined by CHROMagar Candida agar dilution screening and CLSI broth microdilution. 176 (82%) patients were colonized and 59 (27%) patients had symptomatic OPC. Candida albicans was the most prevalent species, though C. glabrata and C. dubliniensis were detected in 29% of isolates. Decreased fluconazole susceptibility occurred in 10% of isolates. Previous ART reduced the risk of OPC, while smoking increased the risk of colonization. Oral yeast colonization and symptomatic infection remain common even with advances in HIV therapy. C. albicans is the most common species, but other yeasts are prevalent and may have decreased susceptibility to fluconazole.
Articles from AIDS Research and Treatment are provided here courtesy of
Hindawi Publishing Corporation