Oral mycoses and other opportunistic infections in HIV: therapy and emerging problems - a workshop report.
Oral mycoses and other opportunistic infections are recognized features of HIV infection even after four decades of the epidemic. The therapeutic options, challenges of therapy, and evolving patterns of opportunistic infections were evaluated by the workshop. It was observed that high Candida counts and infection are still more prevalent in HIV-positive individuals even in the era of antiretroviral therapy. Furthermore, one or more non-Candida albicans are present in some HIV-positive individuals. While Candida species are more virulent in HIV infection, similar virulence may be present in other states of immunosuppression. Consequently, the interplay between host factors and virulence ultimately determines the clinical outcomes. Adverse clinical outcomes such as candidemia and other deep fungal infections are on the increase in HIV infection. Disseminated histoplasmosis and penicilliosis have been reported, especially with low CD4 counts. Even with advances in antifungal therapy, mortality and morbidity from deep fungal infections have not changed significantly. In addition, long-term exposure to common antifungal drugs such as fluconazole has led to the development of antifungal resistance in 6% to 36%. Development of new antifungal therapeutic agents and the use of alternative therapies may offer breakthrough. In addition, effective strategies to enhance the host immune status are being explored.
Department of Oral and Maxillofacial Pathology and Microbiology, Sathyabama University Dental College, Sathyabama University, Chennai, India.
K M
KM
Vidya
Ragas Dental College and Hospital, Chennai, India.
U K
UK
Rao
Excellent Research Laboratory, Phytomedicine and Pharmaceutical Biotechnology Excellence Center, Hat Yai, Songkhla, Thailand.|Natural Products Research Center of Excellence, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla, Thailand.|Graduate School, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
W
W
Nittayananta
Department of Oral Medicine and Traditional Chinese Medicine, Peking University School of Stomatology, Haidian District, Beijing, China.
H
H
Liu
Department of Oral and Maxillofacial Surgery and Oral Pathology, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria.
F J
FJ
Owotade
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000382:microbiology; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000187:drug effects / Q000472:pathogenicity*; D002180:Candidiasis, Oral / Q000188:drug therapy* / Q000382:microbiology; D002353:Carrier State / Q000382:microbiology*; D003226:Congresses as Topic; D025141:Drug Resistance, Fungal; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D000072742:Invasive Fungal Infections / Q000453:epidemiology* / Q000382:microbiology; D008517:Phytotherapy; D028321:Plant Preparations / Q000627:therapeutic use*; D015995:Prevalence
D000935:Antifungal Agents; D028321:Plant Preparations; D015725:Fluconazole
Candida; HIV; antifungal therapy; opportunistic infections