Oral Candida in HIV-infected heterosexuals and intravenous drug users in Thailand.
The objectives of this study were to determine levels of oral yeasts in Thai people at different stages of HIV infection compared with HIV-negative controls, to identify factors associated with the levels of oral Candida, and to determine whether the levels of the organism can be used as a predictive clinical marker in HIV-infected individuals. One hundred and eighty HIV-infected heterosexual persons and intravenous drug users (IVDUs) were enrolled (152 men, 28 women). Eighty-three HIV-free subjects from the same population were included as controls (48 men, 35 women). Oral yeasts were isolated in 103 HIV-infected subjects (57.2%) and 36 HIV-negative controls (43.3%). The mean number of colony forming units (CFU) of oral Candida in the first group was 1.9x10(4) CFU/ml (range 2.2x10(2)-4.0x10(6) CFU/ml), which was significantly different statistically when compared with 1.7x10(3) CFU/ml (range 4.0x10(2)-1.2x10(5) CFU/ml) in the control group (P=0.0000). The following factors are significantly associated statistically with the levels of oral Candida among the subjects (P<0.05): age, stage of HIV infection, total number of lymphocyte cell count, risk group, nutritional status, general health status, weight loss, type of oral lesions and number of oral lesions and number of sites affected. The study revealed that HIV serostatus, stage of HIV infection, and the occurrence of oral lesions among HIV-infected subjects may be predicted by the levels of oral Candida (P<0.05). By using a cut-off point of 2.0x10(3) CFU/ml, the sensitivity and predicitve values of the level of oral Candida on the HIV serostatus was higher than that based on the culture positivity results alone, although the specificity was similar. These findings suggest that, in conjunction with some other clinical signs and laboratory findings, the levels of oral Candida may be used as a predictive marker of disease in HIV infection.
Nittayananta
W
W
Department of Stomatology, Faculty of Dentistry, Faculty of Medicine, Prince of Songkla University, Thailand.
Jealae
S
S
Winn
T
T
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis*; D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000032:analysis; D002175:Candida / Q000254:growth & development; D002180:Candidiasis, Oral / Q000175:diagnosis*; D015169:Colony Count, Microbial; D005260:Female; D015658:HIV Infections / Q000145:classification / Q000150:complications; D018023:HIV Seronegativity; D006304:Health Status; D020010:Heterosexuality; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology; D009752:Nutritional Status; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015819:Substance Abuse, Intravenous; D013785:Thailand; D015431:Weight Loss
D015415:Biomarkers