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Factors associated with increased frequency of HIV-related oral candidiasis
G M McCarthy1, I D Mackie, J Koval
1Division of Oral Biology, University of Western Ontario, London, Canada.
Abstract:
HIV-related oral candidiasis was investigated in 71 HIV-seropositive patients who received interviews, oral examinations and hematologic investigation. Diagnosis of candidiasis was based on clinical signs and examination of PAS-stained smears. The frequency of candidiasis was 24/71 (34%). The clinical presentations were pseudomembranous 8 (11%), erythematous 14 (20%), angular cheilitis 3 (4%). Twenty-six patients (37%) had candidiasis or were receiving antifungal treatment for recurrent pseudomembranous type. Twelve of 13 (92%) patients with AIDS and 14/58 (24%) without AIDS were affected. Bivariate analyses showed significant associations with AIDS, the use of zidovudine, low T4-count, xerostomia; marital status (sometime married), restricted performance status and age of greater than 35 yr. Multivariate logistic regression analysis showed that the presence of xerostomia was an independent and statistically significant predictor of HIV-related oral candidiasis. T4-count and restricted performance status were the second and third most important predictors.
Insights
Xerostomia (dry mouth) is a key predictor of oral candidiasis in HIV patients. This fungal infection, often called thrush, affects 34% of individuals with HIV, especially those with AIDS.
Area of Science:
- Oral medicine
- Infectious diseases
- HIV/AIDS research
Background:
- Oral candidiasis is a common opportunistic infection in individuals with Human Immunodeficiency Virus (HIV).
- Understanding risk factors is crucial for managing oral health in this population.
Purpose of the Study:
- To investigate the frequency and clinical presentations of oral candidiasis in HIV-seropositive patients.
- To identify predictors of HIV-related oral candidiasis.
Main Methods:
- A study involving 71 HIV-seropositive patients.
- Data collection through interviews, oral examinations, and hematologic investigation.
- Diagnosis confirmed by clinical signs and PAS-stained smears.
Main Results:
- 34% of patients had oral candidiasis, with pseudomembranous and erythematous forms being most common.
- Significant associations found with AIDS, zidovudine use, low T4-cell count, xerostomia, and performance status.
- Multivariate analysis identified xerostomia as the strongest independent predictor, followed by T4-cell count and performance status.
Conclusions:
- Xerostomia is a significant independent predictor of oral candidiasis in HIV-infected individuals.
- Early identification and management of xerostomia may help prevent oral candidiasis in this vulnerable group.