Association between etiologic species with CD4 count and clinical features of oral candidiasis among HIV/AIDS patients

Abstract

BackgroundOral candidiasis (OC) is an oral mucosal disorder due toCandidagenus. Its predisposing factor among patients with HIV/AIDS is mainly decreasing CD4 count. OC is commonly caused byCandidaalbicans.As CD4 decreases, the shift toC.non-albicanshas been observed.ObjectiveTo evaluate the association ofCandidaspecies with CD4 count and clinical features in HIV/AIDS patients with OC.Patients and methodsThis is a cross-sectional study. A total of 114 oral rinse solution samples from HIV/AIDS patients with OC were collected.Candidaspecies identification was done by culture in Chromagar followed by VITEK 2. The association ofCandidaspecies with CD4 count and clinical features was analyzed using Pearson'sχ2and Kruskal–Wallis tests.ResultsThere was growth of 149 isolates in culture from 114 patients.C. albicanswas found in 104 (69.7%) isolates.Candidanon-albicans were found in 45 (30.3%) isolates, namelyCandida kruseiin 22 (14.85%),Candida glabratain 12 (8.1%),Candida tropicalisin six (4.05%),Candida dubliniensisin two (1.3%),Candida parapsilosisin two (1.3%), andCandidalipolyticain one (0.7%) isolate.Candidaspecies was significantly associated with clinical types, episode types, pain on swallowing, CD4 count, and antiretroviral (ARV) use among all patients.ConclusionAmong HIV/AIDS patients with OC, growth ofC. albicansonly was more common in higher CD4 count, while mixed growth ofC. albicansandC.non-albicanswas more common in lower CD4 count. Clinical features associated with growth ofC. albicansonly were pseudomembranous type, recurrent OC, absence of pain on swallowing, and patients on ARV, whereas those associated with mixed growth ofC. albicansandC.non-albicanswere cheilitis type, first-episode OC, presence of pain on swallowing, and ARV-naive patients.

Update of the list of qualified presumption of safety (QPS) recommended microbiological agents intentionally added to food or feed as notified to EFSA 18: Suitability of taxonomic units notified to EFSA until March 2023

“…From a total of 85 Candida strains, two were identified as Y. lipolytica. Invasive interventions (central catheter, mechanical ventilation and parenteral nutrition) and the use of antimicrobials increase the risk of neonatal Candida spp.. Murtiastutik et al (2022) isolated 149 yeast strains from 114 HIV/AIDS patients in a hospital in Indonesia. One of the isolates was identified as Y. lipolytica, however, a strain of Candida albicans was also isolated from the same patient.…”