Antimicrobial photodynamic therapy in the treatment of oral candidiasis in HIV-infected patients.
OBJECTIVE
Antimicrobial photodynamic therapy (aPDT) has been used to combat local infections, and it consists of the combination of a photosensitizer, a light source, and reactive oxygen species (ROS) to kill microbial cells. In this study, we evaluated the effectiveness of aPDT in the treatment of candidiasis in HIV-infected patients.


METHODS
Twenty-one patients were divided into three groups. Control group (CG) was treated with the conventional medication for candidiasis (fluconazole 100 mg/day during 14 days). Laser group (LG) was subjected to low-level laser therapy (LLLT), wavelength 660 nm, power of 30 mW, and fluence of 7.5 J/cm(2), in contact with mucosa during 10 sec on the affected point. An aPDT group (aPDTG) was treated with aPDT, that is, combination of a low-power laser and methylene blue 450 μg/mL. Pre-irradiation time was 1 min. Parameters of irradiation were the same ones as for the LG, and patients were single irradiated. Patients were clinically evaluated and culture analysis was performed before, immediately after, and 7, 15, and 30 days after the treatment.


RESULTS
Our results showed that fluconazole was effective; however, it did not prevent the return of the candidiasis in short-term. LLLT per se did not show any reduction on Candida spp. aPDT eradicated 100% of the colonies of this fungus and the patients did not show recurrence of candidiasis up to 30 days after the irradiation.


CONCLUSIONS
These findings suggest that aPDT is a potential approach to oral candidiasis treatment in HIV-infected patients.
Instituto de Pesquisas Energéticas e Nucleares, Comissão Nacional de Energia Nuclear, IPEN-CNEN/SP, São Paulo, Brazil.
Agnes Roberta
AR
Scwingel
Ana Rita Pinheiro
AR
Barcessat
Silvia Cristina
SC
Núñez
Martha Simões
MS
Ribeiro
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000532:radiotherapy*; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002180:Candidiasis, Oral / Q000188:drug therapy / Q000532:radiotherapy*; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D016896:Treatment Outcome
D000935:Antifungal Agents; D015725:Fluconazole