Declining Rates of Oropharyngeal Candidiasis and Carriage of Candida albicans Associated with Trends Toward Reduced Rates of Carriage of Fluconazole-Resistant C. albicans in Human Immunodeficiency Virus—Infected Patients

In order to determine the current prevalence and incidence of fluconazole-resistant oropharyngeal candidiasis among human immunodeficiency virus (HIV)—infected patients, we conducted a prospective observational study of a consecutive series of HIV-infected patients. Of 128 enrolled patients, 70 pati...

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Bibliographic Details
Published in:Clinical infectious diseases 1998-11, Vol.27 (5), p.1291-1294
Main Authors: Martins, Marcelo D., Lozano-Chiu, Mario, Rex, John H.
Format: Article
Language:English
Subjects:
AIDS-Related Opportunistic Infections - drug therapy
AIDS-Related Opportunistic Infections - epidemiology
AIDS/HIV
Anti-HIV Agents - therapeutic use
Antifungal Agents - therapeutic use
Antifungals
Antiretrovirals
Biological and medical sciences
Candida
Candida albicans
Candida albicans - drug effects
Candida albicans - isolation & purification
Candidiasis
Candidiasis, Oral - complications
Candidiasis, Oral - drug therapy
Candidiasis, Oral - epidemiology
Carrier State - epidemiology
Carrier State - microbiology
CD4 Lymphocyte Count
Clinical Articles
Drug Resistance, Microbial
Drug Therapy, Combination
Fluconazole - pharmacology
HIV
Human immunodeficiency virus
Human viral diseases
Humans
Infectious diseases
Medical sciences
Microbial Sensitivity Tests
Mouth - microbiology
Observational studies
Physiological immunosuppression
Prevalence
Prospective Studies
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Viruses
Yeasts
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Summary:In order to determine the current prevalence and incidence of fluconazole-resistant oropharyngeal candidiasis among human immunodeficiency virus (HIV)—infected patients, we conducted a prospective observational study of a consecutive series of HIV-infected patients. Of 128 enrolled patients, 70 patients completed four quarterly follow-up visits over a period of 1 year. Over this period, declining rates of carriage of Candida albicans (from 61% to 39%; P = .008) and of oropharyngeal candidiasis (from 30% to 4%; P < .001) were documented. Trends toward reduction in the frequency of fluconazole-resistant isolates (MIC, ⩾64 µg/mL) were also seen. During the survey period, the mean (median) number of antiretroviral agents used per patient rose from 0.5 (0) to 1.8 (2) (P < .001). Thus, rather than progression, we observed declining rates of oropharyngeal candidiasis, C. albicans carriage, and fluconazole-resistant C. albicans in a cohort of HIV-infected patients treated with increasingly effective antiretroviral therapy.
ISSN:1058-4838
1537-6591
DOI:10.1086/515006