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
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.
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In North American oral candidiasis (HIV/AIDS-positive) patients, the prevalence of fluconazole-resistant C. albicans isolates was found to be between 12% and 22%.
“This has occurred with greatest frequency in the setting of patients suffering from HIV/AIDS during treatment for oropharyngeal candidiasis, where the prevalence of fluconazole-resistant C. albicans isolates in North American oral candidiasis (HIV/AIDS-positive) patients was found to be between 12% and 22%.38–42”
From Molecular and genetic basis of azole antifungal resistance in the opportunistic pathogenic fungus<i>Candida albicans</i> (2020) · cites this paper as [38]
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- Authors
- Martins, M. D., Lozano‐Chiu, M., & Rex, J. H.
- Corresponding author
- Rex, John H.
- ORCID
- Rex, John H.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-11
- Volume
- 27
- Issue
- 5
- Pages
- 1291-1294
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2156624117
- Cited by
- 103
- References
- 24
- Citations by year
- 2026: 1 · 2024: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 2 · 2015: 4 · 2014: 4 · 2013: 2 · 2012: 5
- FWCI
- 3.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › HIV/AIDS oral health manifestations
- Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
- Keywords
- oropharyngeal candidiasis, Candida albicans, fluconazole resistance, HIV infection, antiretroviral therapy, antifungal susceptibility, incidence trends
- MeSH terms
- Antifungal Agents, Candida albicans, Candidiasis, Oral, Carrier State, Drug Resistance, Microbial, Drug Therapy, Combination, Humans, Microbial Sensitivity Tests, Mouth, Prospective Studies, Fluconazole, Prevalence, AIDS-Related Opportunistic Infections, CD4 Lymphocyte Count, Anti-HIV Agents
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