Abstract | BACKGROUND: Progressive cell-mediated immunodeficiency with decrease of CD4+ lymphocyte count to less than or equal to 200 cells/mm3 is a major risk factor for colonization with Candida species and development of candidiasis. Oropharyngeal candidiasis may occur in up to 90% of human immunodeficiency virus (HIV)-infected patients during the course of the disease. This study is to determine the effect of prolonged highly active antiretroviral therapy ( HAART) on oropharyngeal colonization with Candida species and oral candidiasis. METHODS: A prospective, longitudinal follow-up study in HIV-infected patients receiving HAART. RESULTS: The mean CD4+ count increased from 232.5 to 316 cells/mm3 and the proportion of patients whose CD4+ count less than 200 cells/mm3 decreased from 50.0% to 28.9% (p = 0.0003) in patients receiving HAART for at least 2 years. The prevalence of oral candidiasis decreased from 10.6% to 2.1% (p = 0.004). The decrease in Candida colonization was less impressive, falling from 57.8% to 46.5 % (p = 0.06). Of the 142 patients enrolled in at least two surveys, 48 (33.8%) remained colonized with Candida and 42 (29.6%) remained negative. In the remaining 52 patients, 34 switched from culture positive to negative, and an increase in CD4+ lymphocytes was noted in 91.2% of them. Among the 18 patients who switched from culture negative to positive, 61.1% also demonstrated an increase in CD4+ lymphocyte count (p = 0.01). CONCLUSION: These findings indicate that HAART is highly effective in decreasing oral candidiasis in association with a rise in CD4+ lymphocyte counts, but only marginally effective in eliminating Candida from the oropharynx.
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Authors | Yun-Liang Yang, Hsiu-Jung Lo, Chien-Ching Hung, Yichun Li |
Journal | BMC infectious diseases
(BMC Infect Dis)
Vol. 6
Pg. 8
(Jan 20 2006)
ISSN: 1471-2334 [Electronic] England |
PMID | 16423306
(Publication Type: Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Anti-HIV Agents
- Antifungal Agents
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Topics |
- AIDS-Related Opportunistic Infections
(microbiology)
- Adult
- Anti-Bacterial Agents
(therapeutic use)
- Anti-HIV Agents
(administration & dosage, pharmacology, therapeutic use)
- Antifungal Agents
(therapeutic use)
- Antiretroviral Therapy, Highly Active
- CD4 Lymphocyte Count
- Candida
(drug effects, isolation & purification, physiology)
- Candidiasis, Oral
(complications, drug therapy)
- Drug Administration Schedule
- Female
- HIV Infections
(complications, drug therapy)
- Humans
- Longitudinal Studies
- Male
- Oropharynx
(microbiology)
- Prospective Studies
- Risk Factors
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