The occurrence of vulvovaginal Candida species and their antifungal susceptibility pattern in HIV seropositive women in Ahvaz, Southwest Iran

Abstract

Background: Vulvovaginal candidiasis (VVC) is a prevalent infection among HIV-seropositive women that still needs to be subjected to more researches. This study is aimed at determining the occurrence of vulvovaginal Candida species and their antifungal susceptibility pattern in HIV-seropositive women from the Behavioral Disease Counseling Center in Ahvaz, Iran. Method: In this analytical cross-sectional study, 85 HIV-seropositive women with the mean age of 26.15 years (SD. 9.60) were evaluated. Vaginal swabs were collected from women to identify various Candida species through conventional methods and API 20 C AUX system. Antifungal susceptibility testing was done on specimens against Amphotericin B and Azole antifungals. Eventually, all data were analyzed by SPSS. Results: The occurrence of vulvovaginal Candida species was 34.11% (29) among 85 HIV-seropositive women. Out of 29 Candida spp., 18 (62.06%) C. albicans, 6 (20.68%) C. glabrata, 4 (13.79%) C. dubliniensis, and 1 (3.44%) C. krusei were identified. There was no significant association between VVC and some medical variables such as antiretroviral therapy, birth control methods, underlying diseases, and CD4 count (PV > 0.05). However, there was a significant association between VVC and age and pregnancy (PV < 0.05). The most Candida spp. showed considerably resistant to Amphotericin B and Itraconazole while all species were susceptible to Caspofungin. Conclusion: The high occurrence of Candida spp. (34.11%) among HIV-seropositive women is notable, with the highest frequency of C. albicans, C. glabrata and C. dubliniensis, respectively. Also, their notable resistance to Amphotericin B and Azole antifungals necessitates more effective treatments for VVC, particularly in pregnant women.