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Candida infection in HIV positive patients 1985-2007

Christian Traeder1, Susann Kowoll, Keikawus Arastéh

  • 1Vivantes, Auguste-Viktoria-Hospital, Berlin, Germany. christian.traeder@vivantes.de

Mycoses
|September 9, 2008
PubMed

Insights

Candida esophagitis remains a significant issue for HIV patients, with non-albicans species increasing. This suggests potential antifungal resistance and selection due to long-term prophylaxis in HIV care.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • HIV/AIDS Research

Background:

  • Candida species infections, particularly Candida esophagitis, pose a persistent challenge for individuals with HIV.
  • Highly active antiretroviral therapy (HAART) has reduced many opportunistic infections in HIV patients.

Observation:

  • Analysis of over 15,000 hospitalizations (1985-2007) in the AVK cohort revealed an increasing incidence of non-albicans Candida species causing esophagitis.
  • Despite the decline in other opportunistic infections post-HAART, Candida esophagitis rates have not decreased.

Findings:

  • The incidence of Candida esophagitis in HIV patients has remained high, comparable to pre-HAART era levels.
  • There is a notable shift towards non-albicans Candida species in esophagitis cases.

Implications:

  • This trend may indicate the emergence of fluconazole resistance in Candida species.
  • Long-term prophylactic antifungal treatment in HIV-positive patients could be selecting for non-albicans species.
  • Further research into antifungal resistance patterns and treatment strategies for Candida esophagitis in HIV is warranted.

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