Clinical Characteristics and Management Responses in 85 HIV-infected Patients With Oral Candidiasis

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996 Oct;82(4):402-7. doi: 10.1016/s1079-2104(96)80304-0.

Abstract

Eighty-five consecutively seen HIV-positive persons with oral candidiasis were evaluated for clinical characteristics, staging of HIV disease, quantitation of candidal colony formation, and response to systemic antifungal treatment with Nizoral (ketoconazole). Fifty-five had CD4 counts less than 200. There was an inconsistent association between clinical signs, patient symptoms, CD4 counts, and candidal colony-forming units. However, there was a trend toward higher colony-forming unit counts (> 500) in patients with lower CD4 cells (< 200). Sixty-five patients had a complete clinical response to the ketoconazole treatment (200 mg daily for 7 days), even though 81% of posttreatment cultures remained positive. Nonsmokers were more likely to respond to antifungal treatment when compared with smokers, and there was a slight tendency for complete responses when colony-forming unit counts were low. The most common lesion presentation was a combination of the white (pseudomembranous) and red (erythematous) forms. Forty-nine percent had complaints of pain. The variable responses indicated the importance of flexible dose-time and drug considerations in antifungal management. Candida albicans was the predominant species.

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / immunology
  • AIDS-Related Opportunistic Infections / microbiology
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Candidiasis, Oral / drug therapy*
  • Candidiasis, Oral / etiology
  • Candidiasis, Oral / immunology
  • Candidiasis, Oral / microbiology
  • Colony Count, Microbial
  • Dose-Response Relationship, Drug
  • Humans
  • Ketoconazole / administration & dosage
  • Ketoconazole / therapeutic use
  • Smoking

Substances

  • Antifungal Agents
  • Ketoconazole