Oral candidal carriage correlates with CD4+ cell count but not with HIV and highly active antiretroviral therapy status

Parul Sah, Pratik Patel, Chetana Chandrashekar, Suganthi Martena, Mamatha Ballal, Manjayya Hegde, Vasudeva Guddattu, Craig Murdoch, Mohit Sharma, Raghu Radhakrishnan

Research output: Contribution to journalArticle

Abstract

AIM: The occurrence of oropharyngeal candidiasis (OPC) may be influenced by oral candidal carriage (OCC). Although OPC is strongly associated with low CD4+ cell count (400-700 cells/mm3 ) and a lack of highly active antiretroviral therapy (HAART), the effect of these two parameters on OCC is debatable. We investigated the oral candidal carriage, species diversity, antifungal susceptibility and the association of OCC with CD4+ cell count and HAART. METHODS: Oral candidal isolates from 120 HIV+ patients (60 receiving and 60 not receiving HAART) and 60 healthy controls were quantified, and their species determined using standard culture and biochemical methods, followed by antifungal susceptibility testing using the agar dilution method. RESULTS: The OCC was significantly higher in HIV+ patients; Candida albicans was the most frequently isolated species in both groups, followed by Candida tropicalis. Candidal density carriage correlated significantly with CD4+ cell count, but not with HIV and HAART status. Among the isolates from HIV+ patients, 35.4% showed reduced susceptibility to fluconazole. CONCLUSION: HIV status results in significantly elevated rates of OCC C albicans remains the predominant pathogen, although other species are emerging rapidly. Resistance to fluconazole is on the rise, and more efficient treatment strategies need to be implemented.

Original languageEnglish
Pages (from-to)e12438
JournalJournal of investigative and clinical dentistry
Volume10
Issue number4
DOIs
Publication statusPublished - 01-11-2019

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Highly Active Antiretroviral Therapy
CD4 Lymphocyte Count
HIV
Fluconazole
Candidiasis
Candida tropicalis
Candida albicans
Agar

All Science Journal Classification (ASJC) codes

  • Dentistry(all)

Cite this

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title = "Oral candidal carriage correlates with CD4+ cell count but not with HIV and highly active antiretroviral therapy status",
abstract = "AIM: The occurrence of oropharyngeal candidiasis (OPC) may be influenced by oral candidal carriage (OCC). Although OPC is strongly associated with low CD4+ cell count (400-700 cells/mm3 ) and a lack of highly active antiretroviral therapy (HAART), the effect of these two parameters on OCC is debatable. We investigated the oral candidal carriage, species diversity, antifungal susceptibility and the association of OCC with CD4+ cell count and HAART. METHODS: Oral candidal isolates from 120 HIV+ patients (60 receiving and 60 not receiving HAART) and 60 healthy controls were quantified, and their species determined using standard culture and biochemical methods, followed by antifungal susceptibility testing using the agar dilution method. RESULTS: The OCC was significantly higher in HIV+ patients; Candida albicans was the most frequently isolated species in both groups, followed by Candida tropicalis. Candidal density carriage correlated significantly with CD4+ cell count, but not with HIV and HAART status. Among the isolates from HIV+ patients, 35.4{\%} showed reduced susceptibility to fluconazole. CONCLUSION: HIV status results in significantly elevated rates of OCC C albicans remains the predominant pathogen, although other species are emerging rapidly. Resistance to fluconazole is on the rise, and more efficient treatment strategies need to be implemented.",
author = "Parul Sah and Pratik Patel and Chetana Chandrashekar and Suganthi Martena and Mamatha Ballal and Manjayya Hegde and Vasudeva Guddattu and Craig Murdoch and Mohit Sharma and Raghu Radhakrishnan",
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Oral candidal carriage correlates with CD4+ cell count but not with HIV and highly active antiretroviral therapy status. / Sah, Parul; Patel, Pratik; Chandrashekar, Chetana; Martena, Suganthi; Ballal, Mamatha; Hegde, Manjayya; Guddattu, Vasudeva; Murdoch, Craig; Sharma, Mohit; Radhakrishnan, Raghu.

In: Journal of investigative and clinical dentistry, Vol. 10, No. 4, 01.11.2019, p. e12438.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Oral candidal carriage correlates with CD4+ cell count but not with HIV and highly active antiretroviral therapy status

AU - Sah, Parul

AU - Patel, Pratik

AU - Chandrashekar, Chetana

AU - Martena, Suganthi

AU - Ballal, Mamatha

AU - Hegde, Manjayya

AU - Guddattu, Vasudeva

AU - Murdoch, Craig

AU - Sharma, Mohit

AU - Radhakrishnan, Raghu

PY - 2019/11/1

Y1 - 2019/11/1

N2 - AIM: The occurrence of oropharyngeal candidiasis (OPC) may be influenced by oral candidal carriage (OCC). Although OPC is strongly associated with low CD4+ cell count (400-700 cells/mm3 ) and a lack of highly active antiretroviral therapy (HAART), the effect of these two parameters on OCC is debatable. We investigated the oral candidal carriage, species diversity, antifungal susceptibility and the association of OCC with CD4+ cell count and HAART. METHODS: Oral candidal isolates from 120 HIV+ patients (60 receiving and 60 not receiving HAART) and 60 healthy controls were quantified, and their species determined using standard culture and biochemical methods, followed by antifungal susceptibility testing using the agar dilution method. RESULTS: The OCC was significantly higher in HIV+ patients; Candida albicans was the most frequently isolated species in both groups, followed by Candida tropicalis. Candidal density carriage correlated significantly with CD4+ cell count, but not with HIV and HAART status. Among the isolates from HIV+ patients, 35.4% showed reduced susceptibility to fluconazole. CONCLUSION: HIV status results in significantly elevated rates of OCC C albicans remains the predominant pathogen, although other species are emerging rapidly. Resistance to fluconazole is on the rise, and more efficient treatment strategies need to be implemented.

AB - AIM: The occurrence of oropharyngeal candidiasis (OPC) may be influenced by oral candidal carriage (OCC). Although OPC is strongly associated with low CD4+ cell count (400-700 cells/mm3 ) and a lack of highly active antiretroviral therapy (HAART), the effect of these two parameters on OCC is debatable. We investigated the oral candidal carriage, species diversity, antifungal susceptibility and the association of OCC with CD4+ cell count and HAART. METHODS: Oral candidal isolates from 120 HIV+ patients (60 receiving and 60 not receiving HAART) and 60 healthy controls were quantified, and their species determined using standard culture and biochemical methods, followed by antifungal susceptibility testing using the agar dilution method. RESULTS: The OCC was significantly higher in HIV+ patients; Candida albicans was the most frequently isolated species in both groups, followed by Candida tropicalis. Candidal density carriage correlated significantly with CD4+ cell count, but not with HIV and HAART status. Among the isolates from HIV+ patients, 35.4% showed reduced susceptibility to fluconazole. CONCLUSION: HIV status results in significantly elevated rates of OCC C albicans remains the predominant pathogen, although other species are emerging rapidly. Resistance to fluconazole is on the rise, and more efficient treatment strategies need to be implemented.

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SN - 2041-1618

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