title: Declining rates of oropharyngeal candidiasis and carriage of Candida albicans associated with trends toward reduced rates of carriage of fluconazole-resistant C. albicans in human immunodeficiency virus-infected patients.
abstract: In order to determine the current prevalence and incidence of fluconazole-resistant oropharyngeal candidiasis among human immunodeficiency virus (HIV)-infected patients, we conducted a prospective observational study of a consecutive series of HIV-infected patients. Of 128 enrolled patients, 70 patients completed four quarterly follow-up visits over a period of 1 year. Over this period, declining rates of carriage of Candida albicans (from 61% to 39%; P = .008) and of oropharyngeal candidiasis (from 30% to 4%; P < .001) were documented. Trends toward reduction in the frequency of fluconazole-resistant isolates (MIC, > or = 64 micrograms/mL) were also seen. During the survey period, the mean (median) number of antiretroviral agents used per patient rose from 0.5 (0) to 1.8 (2) (P < .001). Thus, rather than progression, we observed declining rates of oropharyngeal candidiasis, C. albicans carriage, and fluconazole-resistant C. albicans in a cohort of HIV-infected patients treated with increasingly effective antiretroviral therapy.
authors.affiliation: Department of Internal Medicine, University of Texas Medical School, Houston, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Martins
authors.forename: M
authors.initials: M
authors.lastname: Lozano-Chiu
authors.forename: J H
authors.initials: JH
authors.lastname: Rex
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology*; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002176:Candida albicans / Q000187:drug effects* / Q000302:isolation & purification; D002180:Candidiasis, Oral / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D015725:Fluconazole / Q000494:pharmacology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D009055:Mouth / Q000382:microbiology; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D019380:Anti-HIV Agents; D000935:Antifungal Agents; D015725:Fluconazole