Oropharyngeal candidiasis and Candida colonization in HIV positive patients in northern India

  • Vijeta Maurya Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
  • Ashutosh Srivastava Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
  • Jyoti Mishra Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
  • Rajni Gaind Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  • Rungmei S.K. Marak Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India
  • Anil Kumar Tripathi Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
  • Mastan Singh Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
  • Vimala Venkatesh Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
Keywords: Orophayngeal candidiasis (OPC), Candida colonization, antiretroviral therapy, CD4 cells, HIV

Abstract

Introduction: Oropharyngeal candidiasis (OPC) is the most common opportunistic fungal infection reported in human immunodeficiency virus (HIV) positive patients worldwide. This prospective study was undertaken to investigate OPC and Candida colonization (CC) and their correlation with CD4+ cell counts and antiretroviral therapy (ART) in HIV-positive patients.

Methodology: In total, 190 HIV-positive patients were enrolled for study in three groups as follows: Group A, 90 patients without ART; Group B, 100 patients undergoing treatment with ART; and Group C, 75 HIV-negative control patients. All HIV patients underwent clinical examination and were subjected to CD4+ cell counts. Swabs were collected from the oral cavity of all individuals and plated on Sabouraud’s dextrose agar. Identification of Candida species was performed by conventional methods.

Results: Candida species were isolated in 84/190 (44.2%) and 20/75 (26.6%) of the HIV-positive subjects and controls respectively (p<0.01). OPC was noted in 21/190 (11%) of the HIV-positive patients. Candida albicans was the most frequently isolated species. Patients with CD4+ cell counts ≤ 200 cells/mm3 were significantly (p<0.001) more frequently colonized (37/63; 58.7%) and infected (18/21; 85.7 %) with Candida species. Candida species was seen in patients with CC and OPC with CD4+cell counts between 201 and 500 (21/63; 33.4% vs 3/21; 14.3%) and > 500 cell/mm3 (5/63; 7.9% versus 0/21 0%) respectively.

Conclusion: OPC and Candida colonization occur more frequently in HIV-positive patients with CD4+ cell counts ≤200 cell/mm3. ART significantly reduces OPC. C. albicans is the most frequently isolated species in both OPC and colonization, suggesting endogenous infection.

Author Biographies

Vijeta Maurya, Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
Senior residentDepatment of MicrobiologyVMMC&Safdarjung Hospital
Ashutosh Srivastava, Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
senior residentDept of MicrobiologyS.G.P.G.I ,Lucknow,U.P
Jyoti Mishra, Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
Senior residentDeparment of lab oncologyAIIMS,Delhi
Rajni Gaind, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
consultant & Associate ProfessorDept of MicrobiologyV.M.M.C. & Safdarjung Hospital New Delhi
Rungmei S.K. Marak, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India
Associate ProfessorDept of MicrobiologyS.G.P.G.I ,Lucknow,U.P
Anil Kumar Tripathi, Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
ProfessorDept of MedicineChhatarapati sahu ji maharaja medical university lucknow,UP,India
Mastan Singh, Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
Professor &HeadDepatment of MicrobiologyChhatarapati sahu ji maharaja medical university lucknow,UP,India
Vimala Venkatesh, Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India
ProfessorDept of MicrobiologyChhatarapati sahu ji maharaja medical university lucknow,UP,India
Published
2013-08-15
How to Cite
1.
Maurya V, Srivastava A, Mishra J, Gaind R, Marak RS, Tripathi AK, Singh M, Venkatesh V (2013) Oropharyngeal candidiasis and Candida colonization in HIV positive patients in northern India. J Infect Dev Ctries 7:608-613. doi: 10.3855/jidc.2801
Section
Original Articles