title: Dynamic analysis of oral Candida carriage, distribution, and antifungal susceptibility in HIV-infected patients during the first year of highly active antiretroviral therapy in Guangxi, China.
abstract: BACKGROUND
  Highly active antiretroviral therapy (HAART) as an effective therapy for immune reconstruction among patients with HIV/AIDS might have influence on oral Candida status. We investigated oral Candida carriage, distribution, and antifungal susceptibility dynamically during the first year of HAART among adult HIV-infected patients in Guangxi, China.
  
  
  METHODS
  Forty-five adult HIV-infected patients who received their first year HAART in the AIDS clinic of the Guangxi Center for Disease Control (CDC) and 31 healthy individuals were recruited. Clinical information and oral examinations were obtained. Oral rinses taken from patients at baseline, 3, 6, 12 months during HAART, respectively, were cultured, and Candida species were identified following standard microbiological techniques. In vitro antifungal susceptibilities were tested by the broth microdilution method.
  
  
  RESULTS
  The oral Candida load decreased gradually in the 45 patients with HIV/AIDS during the first year of HAART (P < 0.050). Among 176 Candida isolates, Candida albicans (114/176) was the predominant species, and Candida parapsilosis (23/62) was the most common non-albicans species. We found the frequency of resistance to fluconazole and itraconazole of Candida isolated from our samples increased (P < 0.05) after 12 months of HAART. In addition, the frequency of C. albicans isolates resistant to fluconazole and itraconazole was on the rise (P < 0.05).
  
  
  CONCLUSIONS
  The Candida load decreased with increased CD4(+) T cell counts, and C. albicans was still the prevailing species. Further, a trend toward more frequent in vitro resistance to fluconazole and itraconazole was observed. Our results provide reference for treatment and prevention of oral candidiasis among this population.
authors.affiliation: Department of Periodontics and Oral Medicine, College of Stomatology, Guangxi Medical University, Guangxi, China; Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University, Guangxi, China.
authors.forename: Lanlan
authors.initials: L
authors.lastname: Jiang
authors.forename: Xiangzhi
authors.initials: X
authors.lastname: Yong
authors.forename: Runying
authors.initials: R
authors.lastname: Li
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Peng
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Qi
authors.initials: Q
authors.lastname: Qin
authors.forename: Linlin
authors.initials: L
authors.lastname: Zhang
authors.forename: Zhenmin
authors.initials: Z
authors.lastname: Liu
authors.forename: Hao
authors.initials: H
authors.lastname: Liang
authors.forename: Renchuan
authors.initials: R
authors.lastname: Tao
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002175:Candida / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification; D002176:Candida albicans / Q000187:drug effects / Q000302:isolation & purification; D002180:Candidiasis, Oral / Q000517:prevention & control; D016022:Case-Control Studies; D015169:Colony Count, Microbial; D025141:Drug Resistance, Fungal / Q000502:physiology*; D005260:Female; D015725:Fluconazole / Q000494:pharmacology; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D011446:Prospective Studies; D012463:Saliva / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D015725:Fluconazole
keywords: China; HAART; HIV/AIDS; antifungal susceptibility; oral Candida