Candida infection as a risk factor for HIV transmission

Numerous epidemiological studies have documented that ulcerative sexually transmitted diseases (STDs), such as syphilis, chancroid, and genital herpes, promote heterosexual human immunodeficiency virus (HIV) transmission. However, the role of vaginal inflammations, such as Candida infection, in HIV acquisition has not been well established, even though, like Trichomona vaginalis infection, it is rapidly emerging as a significant co-factor in HIV transmission.

This study was conducted among a high-risk population of heterosexual women, cohabitating with their HIV-positive male partners, to determine if an association exists between vaginal infections, primarily Candida, and HIV seroconversion. These serodiscordant couples (i.e., one of the persons is HIV positive, and the other is HIV negative) are currently enrolled in an ongoing longitudinal heterosexual discordant couple cohort that is being prospectively followed at Project Sans Francisco (PSF), an HIV Prevention and Research Center in Lusaka, Zambia. A nested case-control study that used retrospective laboratory analyses data obtained from medical, clinical, and laboratory records at PSF was employed.

The findings from this study clearly document that women who seroconverted from HIV-negative status during baseline to HIV-positive status at follow-up were significantly more likely to have vaginal Candida infections than were the correspondingly matched seronegative control women.

These findings suggest that high-risk heterosexual HIV-negative women could benefit from appropriate gynecological management and care regarding the prevention and treatment of vaginal Candida infections, especially in resource-poor environments.