title: Oral candidiasis of HIV-infected children undergoing sequential HIV therapies.
abstract: Candida oral flora from 52 Brazilian HIV-infected children was characterized while they received antiviral monotherapy therapy and subsequently, HAART with the use of protease inhibitor. There was a significant increase in non-C. albicans Candida isolates from 9.6-28.8% (P=0.005) after the children were placed on protease inhibitor therapy. Although Candida albicans still remained the most commonly isolated species, relative presence of C. tropicalis (n=9) followed by C. parapsilosis (n=8) markedly increased in association with protease inhibitor therapy. Furthermore, rare Candida species including C. dubliniensis, C. norvegensis, C. humicula and C. rugosa also appeared after the onset of protease inhibitor therapy. Subsequent investigation of the antifungal sensitivity of these diverse isolates, derived during protease inhibitor therapy, demonstrated some variation in antifungal sensitivity. With notable exceptions, the majority were sensitive to amphotericin B while most C. albicans and non-C. albicans Candida isolates were also susceptible to fluconazole, itraconazole and ketoconazole. Amongst exceptions was a single C. tropicalis isolates which was resistant to fluconazole (MIC>64 microl/ml) and one C. albicans-B isolate which showed cross-resistance to all azoles and amphotericin.
authors.affiliation: Center of Pediatric Investigation, University of Campinas State, Brazil.
authors.forename: Nadja R
authors.initials: NR
authors.lastname: Melo
authors.forename: Hideaki
authors.initials: H
authors.lastname: Taguchi
authors.forename: Vitoria P
authors.initials: VP
authors.lastname: Culhari
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kamei
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Mikami
authors.forename: Stephen N
authors.initials: SN
authors.lastname: Smith
authors.forename: Marluce S
authors.initials: MS
authors.lastname: Vilela
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000382:microbiology; D000293:Adolescent; D000666:Amphotericin B / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology; D023241:Antiretroviral Therapy, Highly Active; D001393:Azoles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D002175:Candida / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D002180:Candidiasis, Oral / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D013045:Species Specificity
chemical_list: D000935:Antifungal Agents; D001393:Azoles; D017320:HIV Protease Inhibitors; D000666:Amphotericin B