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

Clin Infect Dis. 1998 Nov;27(5):1291-4. doi: 10.1086/515006.

Abstract

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, > or = 64 micrograms/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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / epidemiology*
  • Anti-HIV Agents / therapeutic use
  • Antifungal Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Candida albicans / drug effects*
  • Candida albicans / isolation & purification
  • Candidiasis, Oral / complications
  • Candidiasis, Oral / drug therapy
  • Candidiasis, Oral / epidemiology*
  • Carrier State / epidemiology*
  • Carrier State / microbiology
  • Drug Resistance, Microbial
  • Drug Therapy, Combination
  • Fluconazole / pharmacology*
  • Humans
  • Microbial Sensitivity Tests
  • Mouth / microbiology
  • Prevalence
  • Prospective Studies

Substances

  • Anti-HIV Agents
  • Antifungal Agents
  • Fluconazole