(B1) Candida and mycotic infections

Area of Science:

• Infectious Diseases
• HIV/AIDS Research
• Mycology

Background:

• Oral candidiasis (OC) is a frequent mucosal manifestation in individuals with HIV infection.
• Traditionally, CD4 cell counts predicted OC development, but recent data suggest viral load is a stronger indicator.
• The role of biofilms and antifungal resistance in persistent OC requires further investigation.

Purpose of the Study:

• To review oral candidiasis and other mycoses in the context of HIV infection.
• To highlight the shift in understanding prognostic indicators from CD4 counts to viral load for OC.
• To discuss the implications of biofilms, antifungal resistance, and emerging mycoses in HIV patients.

Main Methods:

• Workshop discussion and literature review on oral candidiasis and HIV-associated mycoses.
• Statistical evaluation comparing HIV viral load and CD4 cell counts as predictors for OC.
• Analysis of factors influencing recalcitrant OC, including biofilms and antifungal resistance.

Main Results:

• HIV viral load is a more significant predictor of oral candidiasis than CD4 cell counts.
• Unusual mycoses are more prevalent in HIV patients from developing countries and may indicate disease progression.
• Yeast typing is generally not critical for managing candidiasis, except for Candida glabrata.

Conclusions:

• HIV viral load is a key factor in managing and predicting oral candidiasis.
• Early detection and treatment of oral thrush in infants are vital to reduce perinatal HIV transmission.
• Further research is needed on biofilms and antifungal resistance in recalcitrant OC.