Prevalence of Malassezia species on the skin of HIV-seropositive patients

Abstract

Malassezia is a genus of lipophilic yeasts residing on the skin of warm-blooded animals. The correlation between specific species and their involvement in skin diseases has been well researched. However, only very few studies have investigated the distribution of Malassezia spp. on the healthy skin of patients infected with human immunodeficiency virus (HIV). The purpose of this work was to analyze whether the composition of Malassezia spp. isolated from the skin of the HIV-infected patients differs from that of healthy individuals. The study included a total of 96 subjects, who were divided into two equally sized groups: HIV-seropositive and HIV-seronegative. The specimens were collected from the subjects by swabbing four anatomical sites (face, chest, back, and scalp). Species were identified using phenotype-based methods, and the identification of strains isolated from the HIV-seropositive patients was confirmed by PCR sequencing of the rDNA cluster. Malassezia spp. were isolated from 33 (69%) HIV-seropositive patients and 38 (79%) healthy volunteers. It was found that men were much more likely to have their heads colonized with Malassezia spp. than women. The most prevalent species on the skin of both HIV-seropositive and HIV-seronegative individuals were Malassezia sympodialis, M. globosa, and M. furfur, albeit at different proportions in the two populations. The diversity of Malassezia spp. was the highest on the face of the HIV-seropositive patients (Shannon–Weiner Index H = 1.35) and lowest on the back of the healthy volunteers (H = 0.16). The phenotype- and molecular-based identification methods were congruent at 94.9%. It was observed a tendency that the HIV-seropositive patients had higher CD4+ cell counts, indicating higher colonization with Malassezia spp.

Chronic Diseases Associated with Malassezia Yeast

“…However, the abundance of Malassezia within the gastrointestinal tract deserves a special attention, since most patients had relatively low CD4 cell counts [72]. HIV infection is associated with a depletion of CD4+ cells, especially in Th17 within the gastrointestinal tract [71,95]. Because Th17 cells are known to participate in the immunological response against Malassezia in the skin [71], this intestinal immune dysregulation in HIV patients may be one explanation for the overgrowth of Malassezia in the gastrointestinal tract.…”

“…HIV infection is associated with a depletion of CD4+ cells, especially in Th17 within the gastrointestinal tract [71,95]. Because Th17 cells are known to participate in the immunological response against Malassezia in the skin [71], this intestinal immune dysregulation in HIV patients may be one explanation for the overgrowth of Malassezia in the gastrointestinal tract. This hypothesis remains to be confirmed in future studies which should focus on both the clinical and immunological impacts of the presence of Malassezia in the gastrointestinal tract of HIV patients.…”

“…Whether other non-immune factors related to HIV promote the overgrowth of Malassezia remains to be determined. Regarding the difference in the prevalence of Malassezia between HIV and non-HIV patients, a recent study reported a positive culture rate of 69% and 79% in 48 HIV and 48 non-HIV patients, respectively [71]. They found that patients with high CD4 cells had relatively high colonization rates, but the difference with the other groups was not statistically significant.…”

Chronic Diseases Associated with Malassezia Yeast

“…However, the abundance of Malassezia within the gastrointestinal tract deserves a special attention, since most patients had relatively low CD4 cell counts [71]. HIV infection is associated with a depletion of CD4+ cells, especially in Th17 within the gastrointestinal tract [70,94]. Because Th17 cells are known to participate in the immunological response against Malassezia in the skin [70], this intestinal immune dysregulation in HIV patients may be one explanation for the overgrowth of Malassezia in the gastrointestinal tract.…”

“…Whether other non-immune factors related to HIV promote the overgrowth of Malassezia remains to be determined. Regarding the difference in the prevalence of Malassezia between HIV and non-HIV patients, a recent study reported a positive culture rate of 69% and 79% in 48 HIV and 48 non-HIV patients, respectively [70]. They found that patients with high CD4 cells had relatively high colonization rates, but the difference with the other groups was not statistically significant.…”