Clinical characteristics and management responses in 85 HIV-infected patients with oral candidiasis.
Eighty-five consecutively seen HIV-positive persons with oral candidiasis were evaluated for clinical characteristics, staging of HIV disease, quantitation of candidal colony formation, and response to systemic antifungal treatment with Nizoral (ketoconazole). Fifty-five had CD4 counts less than 200. There was an inconsistent association between clinical signs, patient symptoms, CD4 counts, and candidal colony-forming units. However, there was a trend toward higher colony-forming unit counts (> 500) in patients with lower CD4 cells (< 200). Sixty-five patients had a complete clinical response to the ketoconazole treatment (200 mg daily for 7 days), even though 81% of posttreatment cultures remained positive. Nonsmokers were more likely to respond to antifungal treatment when compared with smokers, and there was a slight tendency for complete responses when colony-forming unit counts were low. The most common lesion presentation was a combination of the white (pseudomembranous) and red (erythematous) forms. Forty-nine percent had complaints of pain. The variable responses indicated the importance of flexible dose-time and drug considerations in antifungal management. Candida albicans was the predominant species.
Silverman
S
S
Division of Oral Medicine, School of Dentistry, University of California, San Francisco, USA.
Gallo
J W
JW
McKnight
M L
ML
Mayer
P
P
deSanz
S
S
Tan
M M
MM
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002180:Candidiasis, Oral / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology / Q000382:microbiology; D015169:Colony Count, Microbial; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007654:Ketoconazole / Q000008:administration & dosage / Q000627:therapeutic use; D012907:Smoking
D000935:Antifungal Agents; D007654:Ketoconazole