Chronic vaginal candidiasis in women with human immunodeficiency virus infection

Twenty-four percent (7/29) of human immunodeficiency virus-infected women seen at Walter Reed Army Medical Center between 1983 and 1986 presented with a history of chronic refractory vaginal candidiasis. In addition to vaginal candidiasis, all patients were found to have oral thrush on physical examination, severe T-helper cell depletion (mean T-helper cell count of 90), and markedly decreased T4/T8 ratios (mean, 0.3); six of seven women were anergic by delayed-type hypersensitivity skin testing. The conditions of six (86%) of these seven women have progressed to acquired immunodeficiency syndrome (WR6 classification). Chronic refractory vaginal candidiasis may be a presenting symptom of human immunodeficiency virus infection. Women with human immunodeficiency virus infection and unexplained oral and vaginal candidiasis are at high risk to develop other opportunistic infections.