Oral fungi in HIV: challenges in antifungal therapies.
Oral candidiasis (OC) caused by Candida species is a common fungal infection among HIV-infected individuals. Despite the wide use of antiretroviral therapy (ART) resulting in a declined prevalence, OC remains the most common oral lesions seen in those living with HIV/AIDS. Various topical and systemic antifungal drugs are available to treat OC. However, due to the patients' immunodeficiency and the nature of OC as biofilm-associated infection, relapse is frequently observed after cessation of antifungal therapy. In addition, long-term antifungal therapy may lead to drug resistance. This review article addressed three major challenges in the treatment of OC in HIV infection including antifungal drug resistance, biofilm-associated infection of OC, and the host underlying immunodeficiency. To reduce the risks of antifungal drug resistance, the author recommends that future studies should focus on herbal plant-derived compounds with antifungal activity that may be used in combination with the drugs. Also, it is recommended that more research should be carried out to explore how to enhance the host innate immunity against oral Candida.
Excellent Research Laboratory, Phytomedicine and Pharmaceutical Biotechnology Excellence Center, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, Thailand.|Natural Product Research Center of Excellence, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
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Nittayananta
D000935:Antifungal Agents / Q000627:therapeutic use*; D018441:Biofilms; D002180:Candidiasis, Oral / Q000188:drug therapy*; D025141:Drug Resistance, Fungal; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D006801:Humans; D007113:Immunity, Innate / Q000187:drug effects; D018928:Immunity, Mucosal / Q000187:drug effects; D008517:Phytotherapy; D028321:Plant Preparations / Q000494:pharmacology / Q000627:therapeutic use*
D000935:Antifungal Agents; D028321:Plant Preparations
Candida; HIV; Houttuynia cordata; chlorhexidine; ellagic acid; fluconazole; hBD2; lawsone methyl ether; oral candidiasis; secretory leukocyte protease inhibitor