title: Oral Candida carriage and immune status in Thai human immunodeficiency virus-infected individuals.
abstract: Oral candidiasis is a common opportunistic infection among human immunodeficiency virus (HIV)-infected individuals, with growing concerns about the emergence of non-albicans species with resistance to antifungal agents. This cross-sectional study determined the prevalence of oral Candida species in Thai HIV-infected adults and factors affecting their colonization. Candida species were identified from oral rinse samples of 60 HIV-infected participants of the MTCT-Plus initiative and 49 healthy controls by culture-based and molecular assays. The prevalence of oral Candida carriage was similar in HIV-infected patients (56.6 %) and in controls (55.1 %, P = 0.87). Candida albicans was the most predominant species in both groups (94.1 % of Candida carriers in HIV, 88.9 % in control). Interestingly, Candida dubliniensis was the second most common species in controls (29.6 %) and the third in HIV-infected patients (11.8 %, P = 0.08). Multivariate analysis showed that, amongst HIV-infected individuals, CD4 count <200 cells mm(-3) was associated with increased prevalence of oral carriage of both C. albicans (P = 0.03) and non-albicans species (P = 0.03). Moreover, patients with tuberculosis infection had a higher prevalence of the non-albicans species than those without (P = 0.03). Intriguingly, contraceptive use was also associated positively with non-albicans and multi-species carriage (P = 0.04 for both). However, use of antiretroviral drugs protected the patients from Candida carriage (P = 0.03), especially from C. albicans (P = 0.02). In conclusion, while HIV-infected individuals had a similar prevalence of oral Candida carriage to that of the control group, host immune status, tuberculosis infection, and contraceptive use may influence oral colonization of Candida, especially of the non-albicans species.
authors.affiliation: Department of Microbiology and DRU on Oral Microbiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Panida
authors.initials: P
authors.lastname: Thanyasrisung
authors.affiliation: Interdepartmental Program in Medical Microbiology, Graduate School, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Piyanate
authors.initials: P
authors.lastname: Kesakomol
authors.affiliation: Department of Microbiology and DRU on Oral Microbiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Patchara
authors.initials: P
authors.lastname: Pipattanagovit
authors.affiliation: Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Pornpan
authors.initials: P
authors.lastname: Youngnak-Piboonratanakit
authors.affiliation: Department of Community Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Waranuch
authors.initials: W
authors.lastname: Pitiphat
authors.affiliation: Department of Microbiology and DRU on Oral Microbiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Oranart
authors.initials: O
authors.lastname: Matangkasombut
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002175:Candida / Q000145:classification / Q000302:isolation & purification*; D002180:Candidiasis, Oral / Q000453:epidemiology* / Q000382:microbiology*; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013785:Thailand / Q000453:epidemiology; D014376:Tuberculosis / Q000150:complications; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents