Salivary anticandidal activity and saliva composition in an HIV‐infected cohort

Abstract

This study investigated salivary anticandidal activity and salivary composition in stimulated whole saliva of 18 advanced HIV-infected patients and compared these values to healthy controls. Stimulated whole saliva from HIV-infected patients showed decreased anticandidal activity. The flow rate was reduced by 40% as compared with controls. The saliva flow rate for HIV-infected patients who had recoverable yeast in their saliva was reduced as compared to HIV-infected patients without recoverable yeast. For HIV-infected patients, the saliva concentrations of lactoferrin, secretory IgA and Cl- were increased while the secretion rate of lysozyme, total protein and K+ were reduced. There was no difference in any parameter as a function of taking the antifungal drug fluconazole. There was no association between salivary anticandidal activity and any salivary component. This study shows reduced anticandidal activity and salivary flow rate in HIV-infected patients. These alterations may contribute to their increased incidence of oral candidal infections.

In vitro antifungal susceptibility of Candida spp. oral isolates from HIV-positive patients and control individuals

“…The prevalence of oral candidosis in HIV-positive patients appears to be correlated to the severity of immunological disfunction. 5,6 The occurrence of oral candidosis at initial stages of AIDS is common, particularly when the CD4 T cell count is low (400-700 cells/mm³). 5 The widespread use of antifungal agents to prevent the occurrence of oral candidosis in HIV-infected patients has been cited as an important factor for the positive selection of non-albicans species as opportunistic pathogens; these species have different susceptibilities to the antifungal agents utilized to treat C. albicans.…”

“…5,6 The occurrence of oral candidosis at initial stages of AIDS is common, particularly when the CD4 T cell count is low (400-700 cells/mm³). 5 The widespread use of antifungal agents to prevent the occurrence of oral candidosis in HIV-infected patients has been cited as an important factor for the positive selection of non-albicans species as opportunistic pathogens; these species have different susceptibilities to the antifungal agents utilized to treat C. albicans. 7 Certain non-albicans species, such as C. glabrata and C. krusei, are inherently less susceptible to fluconazole than C. albicans and have been isolated with increasing frequency in HIV-infected patients.…”

Effect of combination antiretroviral therapy on the frequency of oral candidiasis in HIV/AIDS patient

“…10,11,12 The presence of oral candidiasis in HIV-infected and AIDS patients was associated with a number factors including low CD4 counts, increased viral load, xerostomia, age and Secretory aspartyl proteinase (Sap), extracellular hydrolytic enzyme was product by Candida. 7,10,13,14 Oral candidiasis occurs more frequently in HIVinfected patients with low CD4 counts. Imam et al found a statistically significant increase in the frequency of HIVrelated oral candidiaisis in patients with CD4 counts of less than 300 cells/mm 3 .…”

“…10,11 The prevalence ranges between 30 and 60% among HIV-infected subjects and reaches 90% in patients with AIDS. 12,13 Oral candidiasis in HIV-infected and AIDS patients may present as pseudomembranous, erythematous, hyperplastic and angular cheilitis variants. 10,11,12 The presence of oral candidiasis in HIV-infected and AIDS patients was associated with a number factors including low CD4 counts, increased viral load, xerostomia, age and Secretory aspartyl proteinase (Sap), extracellular hydrolytic enzyme was product by Candida.…”

“…This decrease in salivary anticandidal activity in AIDS patients has been attributed to a decrease in the concentration of salivary histatines and/or to dysfunction of these proteins. 13 Histatine are a family of histidine-rich polypeptides and are the major antifungal proteins present in human saliva. In addition, many of the specific proteins secreted by the salivary glands have antifungal activities like Ig A, lactoferin and lysozyme were decreased too.…”