Oral colonization by Candida species in AIDS pediatric patients.
The aim of this study was to assess the prevalence of factors associated with oral colonization by Candida spp. in pediatric patients with AIDS. The sample comprised of 117 children. Clinical status, medicines in use, and laboratory findings were obtained from hospital records; sociodemographic data were given by relatives. A dental examination assessed the prevalence of dental caries. The prevalence of oral colonization by Candida was 62%. Only seven children presented clinical manifestation of oral candidosis despite their high viral load index and low-for-age CD4 count. Candida colonization was directly associated with frequent use of antibiotics (prevalence ratio [PR] = 1.44), sulfa drugs (PR = 1.23), alteration in the oral mucosa (PR = 1.55), and untreated dental caries (PR = 1.93). It was inversely associated with the use of antiretroviral therapies (PR = 0.65). Candida albicans was the most frequently detected species (80%); phenotypic tests did not detect C. dubliniensis strains. This study observed a low prevalence of Candida-related oral lesions in these patients, which is compatible with the hypothesis that antiretroviral medicines may have contributed to reducing oral manifestations from Candida infection. The high prevalence of Candida colonization in HIV+/AIDS children with untreated dental caries reinforces the importance of oral health care in interdisciplinary health units that assist these patients.
Department of Oral Diagnosis, School of Dentistry, University of São Paulo, Brazil. domaneschi@usp.br
C
C
Domaneschi
D B
DB
Massarente
R S
RS
de Freitas
H H
HH
de Sousa Marques
C R
CR
Paula
D A
DA
Migliari
J L F
JL
Antunes
D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology; D000163:Acquired Immunodeficiency Syndrome / Q000382:microbiology*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002175:Candida / Q000254:growth & development*; D002176:Candida albicans / Q000254:growth & development; D002180:Candidiasis, Oral / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D003729:Dental Care; D003731:Dental Caries / Q000145:classification; D005260:Female; D006678:HIV / Q000302:isolation & purification; D054303:HIV Reverse Transcriptase / Q000037:antagonists & inhibitors; D006801:Humans; D008297:Male; D009055:Mouth / Q000382:microbiology*; D009061:Mouth Mucosa / Q000382:microbiology; D009910:Oral Hygiene; D010159:Palate / Q000382:microbiology; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013424:Sulfanilamides / Q000627:therapeutic use; D014059:Tongue / Q000382:microbiology; D019562:Viral Load
D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents; D000890:Anti-Infective Agents; D013424:Sulfanilamides; D054303:HIV Reverse Transcriptase