Host factors associated with HIV-related oral candidiasis. A review

Human immunodeficiency virus (HIV)-related oral candidiasis affects approximately one third of HIV-seropositive patients and more than 90% of patients with AIDS. It is necessary to identify patients who have a greater risk of candidiasis developing, so that interventions can be designed to reduce the frequency. This is particularly important because there is evidence that Candida species are immunosuppressive and therefore candidiasis may adversely affect the prognosis of patients with HIV. Susceptibility to HIV-related oral candidiasis is associated with xerostomia, severity of disease, depression of cell-mediated immunity, and older age (greater than 35 years). The frequency of HIV-related oral candidiasis is notably increased when the CD4 lymphocyte count falls to less than 300 cells/mm3. Xerostomia appears to be a better predictor of HIV-related oral candidiasis than CD4 count and should be prevented (e.g., by avoiding xerogenic drugs) and treated, when necessary, to minimize the risk of oral candidiasis.