Association of oral candidal carriage, candidal density and CD4 count among normal, HIV patients with HAART and without HAART

Abstract

Objectives: Oral candidiasis is considered one of the most frequent opportunistic infections in Human Immunodeficiency Virus (HIV) individuals. Symptomatic candida colonization of the oral and vaginal mucosal surfaces is closely correlated with the severity of cellular immunodeficiency in HIV infection. HAART is considered as the mainstay treatment that shows a decrease in the incidence of opportunistic diseases, including oral lesions. The current study was designed to analyse the candidal carriage rate and candidal density in HIV patients undergoing HAART and without HAART. Methods: The study population comprised of 120 subjects and was equally distributed into 3 groups: Group 1 (HIV patients with HAART), Group 2 (HIV patients without HAART), and Group 3 (healthy subjects as controls). The oral rinse samples from all the groups were collected and incubated for candidal growth. The complete growth of any candidal colonies on the culture plates was recorded as a positive candidal carriage. The number of colonies forming units per mL was calculated for candidal density. Results: The candidal carriage rate in the HIV patients undergoing HAART was higher than in subjects naïve to HAART. A higher number of patients with HAART therapy showed candidal density <2000 CFUs/mL. There was a reduction of oral candidiasis seen in patients with non-protease inhibitor HAART therapy. There was no significant association found between the candidal carriage rates and candidal density with CD4 lymphocyte count. HIV individuals undergoing HAART therapy showed higher candidal carriage rate and lower candidal density than the non-HAART group. Conclusion: Candidal density is a more valuable marker in predicting the development of oral candidiasis than candidal carriage rate. Reduction in the occurrence of oral candidiasis is also seen in patients who are on NNRTI HAART therapy.

Keywords

• Oral candidiasis
• HAART
• Candidal carriage
• Candidal density
• CD4 T cell