Treatment of oral candidiasis in HIV infection

Oral candidiasis is one of the most common clinical features of HIV infection. The lesion occurs in three predominant forms, and the two intraoral examples, pseudomembranous and erythematous, are equally predictive of the development of AIDS, independent of CD4 counts. The predominant species is C. albicans, although other species are occasionally found. Some studies claim correlation of salivary Candida counts with CD4 numbers or clinical stage of HIV-related disease, but this approach has not been used widely in HIV staging. Therapy with a variety of antifungal agents, including both topical and systemic drugs, is effective. New slow-release oral topical drug delivery systems may prove to be useful. Recently, examples of resistance to some drugs have been reported. Resistance may be associated with the emergence of different species.