Oral Candidiasis in High-Risk Patients as the Initial Manifestation of the Acquired Immunodeficiency Syndrome

Abstract

We studied the frequency with which unexplained oral candidiasis led to unequivocal acquired immunodeficiency syndrome (AIDS) in patients at risk. Twenty-two previously healthy adults with unexplained oral candidiasis, of whom the 19 tested had a reversed T4/T8 ratio and 20 had generalized lymphadenopathy, were compared with 20 similar patients with a reversed T4/T8 ratio and generalized lymphadenopathy who did not have oral candidiasis. All were intravenous-drug abusers, homosexual or bisexual men, or both. Thirteen of the 22 patients with oral candidiasis (59 per cent) acquired a major opportunistic infection or Kaposi's sarcoma at a median of three months (range, 1 to 23) as compared with none of 20 patients with generalized lymphadenopathy and immunodeficiency but without candidiasis who were followed for a median of 12 months (range, 5 to 21) (P less than 0.001). AIDS developed in 12 of 15 patients with candidiasis and T4/T8 ratios less than or equal to 0.51, as compared with none of four with ratios equal to or greater than 0.60 (P less than 0.01). We conclude that in patients at high risk for AIDS, the presence of unexplained oral candidiasis predicts the development of serious opportunistic infections more than 50 per cent of the time. Whether the remainder will have AIDS is not yet known.

Bone marrow colony-formation in vitro after infection of genetically defined inbred mice with Candida albicans

“…Evidence to date suggests that recovery from infection is determined by cellmediated immune responses, acting via cytokine enhancement of the candidacidal activities of phagocytic cells [1]. Both clinical observations [2] and experimental models [3] indicate that defective cell-mediated immune responses predispose to oro-pharyngeal candidiasis; however, susceptibility to systemic disease is often associated with a dysfunctional response of neutrophils or mononuclear phagocytes [4,5].…”

Baofukang suppository promotes the repair of vaginal epithelial cells in response to candida albicans

“…IL-2 and IL-4 are the classically representative of Th1 and Th2 cytokines, respectively (Fidel and Sobel 1994;Romani 1999;Woo et al 2015). A strong role for Th1-type cellmediated immunity against Candida was demonstrated by various experimental models (Klein et al 1984;Clift 1984). An increased Th1/Th2 ratio (IL-2/IL-4) is associated with the activation of cell-mediated immunity and would be potentially beneficial for pathogen or cancer elimination, while a decreased ratio would raise the risk of inflammation progression.…”

Oral and vaginal epithelial cell anti‐Candida activity is acid labile and does not require live epithelial cells

“…Following the incubation, the cells were washed with PBS and cell viability was assessed by Trypan blue dye exclusion and confirmed by propidium iodide (PI) and fluorescein diacetate (FDA) vital staining. For PI/FDA staining, FDA (50 μg/ml, stains live cells) and PI (1 μg/ml, stains dead cells) (Sigma) (3,8,10) were added simultaneously to the epithelial cell pellets and placed in the dark for 30 min at room temperature. Following the incubation, the epithelial cells were washed with PBS followed by a second wash with 20% FBS and then a final wash with PBS.…”

“…candidiasis (OPC) is a significant problem in immunocompromised individuals and is extremely common during human immunodeficiency virus (HIV) infection, especially when CD4 + T cells are reduced (8,9). Vulvovaginal candidiasis (VVC) affects 75% of women at least once in their reproductive years, and it is equally common in both immunocompetent and immunocompromised women (11,12).…”