Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/198301
Type: Artigo de periódico
Title: Clinical And Microbiological Assessment Of Patients With A Long-term Diagnosis Of Human Immunodeficiency Virus Infection And Candida Oral Colonization.
Author: Delgado, A C D
de Jesus Pedro, R
Aoki, F H
Resende, M R
Trabasso, P
Colombo, A L
de Oliveira, M S M
Mikami, Y
Moretti, M L
Abstract: The objective of this study was to evaluate Candida oral colonization in human immunodeficiency virus (HIV)-infected patients undergoing long-term highly active antiretroviral therapy (ARV). The cross-sectional study included 331 HIV patients, diagnosed from 1983 to 2003. Oral swabs were performed, and Candida species were determined using ID 32C. Isolates were tested for antifungal susceptibility. Clinical and laboratory data were collected to identify the association with Candida colonization. In total, 161 Candida isolates were detected among 147 of the 331 patients (44%), independently of the time when HIV infection was diagnosed. Candida albicans strains represented 137 (85%) of the isolates, and were susceptible to all of the tested antifungal drugs. Among the non-C. albicans strains, six isolates were dose-dependently susceptible to fluconazole, nine to itraconazole, and seven to ketoconazole. The isolation of Candida was significantly higher in patients with virological failure (83/147; p 0.0002) and CD4(+) T-lymphocyte counts <200 cells/mm(3) (30/83; p 0.0003). Recovery of Candida in the oral cavity was independent of protease inhibitor (PI) usage (p 0.60). Colonized patients typically underwent salvage therapy (p 0.003), and had more episodes of opportunistic fungal infections (p 0.046) and malignancies (p 0.004).Oral Candida colonization in patients under ARV therapy was associated with the immunosupressed status of HIV-infected patients, i.e. low number of CD4(+) T-cells per cubic millimetre, failure of ARV therapy (salvage therapy), and higher number of opportunistic infections and malignancies. Despite the fact that PIs have in vitro antifungal activity, the use of this class of antiretroviral agent did not influence the presence of Candida in the oral cavity of AIDS patients.
Subject: Adult
Anti-hiv Agents
Antifungal Agents
Antiretroviral Therapy, Highly Active
Cd4 Lymphocyte Count
Candida
Candidiasis, Oral
Cross-sectional Studies
Female
Hiv
Hiv Infections
Humans
Immunocompromised Host
Male
Microbial Sensitivity Tests
Neoplasms
Salvage Therapy
Treatment Failure
Viral Load
Citation: Clinical Microbiology And Infection : The Official Publication Of The European Society Of Clinical Microbiology And Infectious Diseases. v. 15, n. 4, p. 364-71, 2009-Apr.
Rights: fechado
Identifier DOI: 
Address: http://www.ncbi.nlm.nih.gov/pubmed/19431223
Date Issue: 2009
Appears in Collections:Unicamp - Artigos e Outros Documentos

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