Persistent oral and urinary Candida spp. carriage in Italian HIV-seropositive asymptomatic subjects

The aim of the present study was to ascertain frequency and persistence of Candida spp. oral and urinary carriage in asymptomatic, HAART-naive HIV-seropositive subjects who had not undergone therapy with antimycotic drugs, and whose CD4+ lymphocyte count was greater than 200/microl. Oral carriage was the most common Candida spp. carriage (63.0% of the subjects), while candiduria was more rarely observed (6.5%). C. albicans was recovered from the majority of the subjects examined (56.5%), followed by C. krusey (4.3%), C. tropicalis (2.2%) and C. dubliniensis (2.2%). C. albicans was also isolated from two urinary carriers (4.3%) and C. glabrata from another one (2.2%). The same C. albicans clone was repeatedly isolated from 14 out of 15 oral carriers while the same clone of C. dubliniensis was repeatedly isolated from one carrier, as shown by the persistence of RAPD fingerprint of serial isolates during one year of follow-up. Since persistence of Candida spp. carriage may influence the development of clinical candidiasis in immunocompromised hosts, monitoring of the carrier status could be useful for preventing clinical thrush in HIV-seropositive subjects.