Oral <I>Candida</I> in HIV-infected heterosexual persons and intravenous drug users in Thailand

Oral Candida in HIV-infected heterosexual persons and intravenous drug users in Thailand
เชื้อราแคนดิดาในช่องปากในผู้ติดเชื้อเอชไอวีกลุ่มรักต่างเพศ และกลุ่มผู้ติดยาเสพติดชนิด ฉีดเข้าเส้นในประเทศไทย

Wipawee Nittayananta, Assoc. Prof., D. of Stomatology, F. of Dentistry, PSU.
Sureerath Jealae, Microbiology Unit, F. of Medicine, PSU.
Than Winn, Epidemiology Unit, F. of Medicine, PSU.
Corresponding e-mail : nwipawee@ratree.psu.ac.th

Grant : Prince of Songkla University
Published : Research Report
Key words : oral Candida, oral lesion, oral candidiasis, AIDS, heterosexual, HIV, intravenous drug user, risk factor, Thailand

The purpose of this study was to determine levels of oral yeasts in Thai people with different status of HIV-infection compared to HIV-negative controls. Two hundred and seventy-five HIV-infected heterosexual persons and intravenous drug users (IVDUs) were enrolled (152 males, 28 females). Eighty-three HIV-free subjects from the same population, were included as controls (48 males, 35 females). Oral yeasts were isolated in 103 HIV-infected subjects (57.2%) and in 30 HIV-negative controls (36.1%). Mean of the colony forming unit (CFU) of oral Candida in the first group was 1.9x10⁴ CFU/ml (range 2.2x10² - 4.0x10⁶ CFU/ml), which was statistically significantly different when compared to 1.7x10³ CFU/ml (range 4.0x10² - 1.2x10⁵ CFU/ml) of the latter one (P=0.0000). The following factors are statistically significantly associated with the levels of oral Candida among the subjects (P<0.05); age, stage, total number of lymphocyte cell count, risk group, weightloss, nu-tritional status, general health status, type of oral lesions, number of oral lesions, number of sites affected. The study reveals that HIV serostatus, stage of HIV infection, and the occurrence of oral lesions among HIV-infected subjects may be predicted by the levels of oral Candida (P<0.05). By using a cut-off point 2.0x103 CFU/ml, the sensitivity and predictive values of the level of oral Candida on the HIV serostatus is higher than those based on the culture positivity results. The levels of specificity, however, is the same in both cases. These findings suggest that the levels of oral Candida may be used as a predictive marker in HIV-infected individuals, or among those in high risk categories.

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