Anti-retroviral therapy with protease inhibitors decreases virulence enzyme expression in vivo by Candida albicans without selection of avirulent fungus strains or decreasing their anti-mycotic susceptibility.
Highly active anti-retroviral therapies (HAART) with human immunodeficiency virus (HIV) protease inhibitors (PIs) or nonnucleoside reverse-transcriptase inhibitors (NNRTI) were compared for their effect on prevalence, aspartyl proteinase (Sap) production and the biotypes and anti-mycotic sequential susceptibility of Candida spp. isolates from the oral cavity in a longitudinal prospective study. HAART-PI, but not HAART-NNRTI strongly inhibited Sap expression in the oral cavity without exerting any consistent effect on the role of Candida spp. isolation or selection of low virulence or anti-mycotic resistant fungus biotype. More importantly, the sequential isolates of Candida albicans from HAART-PI, but not those from suspended HAART-NNRTI, showed an increased Sap production in vitro. While further demonstrating that HIV-PI inhibit Sap expressions, our results do not support the view that the mentioned inhibition could eliminate Candida or its selection of the oral cavity.
De Bernardis
Flavia
F
Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome 00161, Italy. fdberna@iss.it
Tacconelli
Evelina
E
Mondello
Francesca
F
Cataldo
Adriana
A
Arancia
Silvia
S
Cauda
Roberto
R
Cassone
Antonio
A
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D016282:Aspartic Acid Endopeptidases / Q000378:metabolism*; D002175:Candida / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification / Q000472:pathogenicity; D002180:Candidiasis, Oral / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009960:Oropharynx / Q000382:microbiology; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D012463:Saliva / Q000382:microbiology; D014774:Virulence
D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D016282:Aspartic Acid Endopeptidases