Are Candida albicans isolates from the oral cavity of HIV-infected patients more virulent than from non-HIV-infected patients? Systematic review and meta-analysis

Orlandini, Renata Klemp; Bepu, Davi Ariel Nobuo; Saraiva, Maria da Conceição Pereira; Bollela, Valdes Roberto; Motta, Ana Carolina Fragoso; Lourenço, Alan Grupioni

doi:10.1016/j.micpath.2020.104477

Cited by 12 publications

(15 citation statements)

References 46 publications

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“…Oral candidiasis (OC) is among the most common opportunistic infections among PLWH, with an estimated prevalence of between 15% and 80% in adults living with HIV. The OC is a fungal infection caused by the proliferation of different strains such as Candida albicans, Candida tropicalis, Candida parapsilosis, Candida glabrata, Candida krusei, and Candida dubliniensis and is usually associated with low CD4+ cell counts and risk factors such as smoking, being an important marker for the individual's immunity status and among the clinical features of OC we cite [112][113][114][115][116][117][118][119][120]:…”

Section: Oral Candidiasismentioning

confidence: 99%

“…Currently, three types of OC are observed: pseudomembranous candidiasis, erythematous candidiasis, and angular cheilitis [112][113][114][115][116][117][118][119][120].…”

Section: • Dysgeusia or Ageusia;mentioning

confidence: 99%

“…Such plaques are formed by a mixture of fungal hyphae, desquamated epithelium, and proinflammatory cells that, when removed, leave the underlying surface red or bleeding. As for the clinical diagnosis, it is made through clinical symptoms, and the histological diagnosis can be used through the direct smear [112][113][114][115][116][117][118].…”

Section: Pseudomembraneous Candidiasismentioning

confidence: 99%

“…In most cases, these lesions present characteristic symptoms such as burning mouth and altered taste. As for the clinical diagnosis, it is made through clinical symptoms, and the histological diagnosis can be used through incisional biopsy [112][113][114][115][116][117][118].…”

Section: Erythematous Candidiasismentioning

confidence: 99%

See 3 more Smart Citations

HIV Infection and Oral Manifestations: An Update

Fonseca¹,

Laurentino²,

Machado³

et al. 2023

Infectious Diseases

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Human immunodeficiency virus (HIV) causes a complete depletion of the immune system; it has been a major health issue around the world since the 1980s, and due to the reduction of CD4+ T lymphocytes levels, it can trigger various opportunistic infections. Oral lesions are usually accurate indicators of immunosuppression because these oral manifestations may occur as a result of the compromised immune system caused by HIV infection; therefore, oral lesions might be initial and common clinical features in people living with HIV. So, it is necessary to evaluate and understand the mechanism, prevalence, and risk factors of oral lesions to avoid the increase morbidity among those with oral diseases.

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Section: Oral Candidiasismentioning

confidence: 99%

“…Currently, three types of OC are observed: pseudomembranous candidiasis, erythematous candidiasis, and angular cheilitis [112][113][114][115][116][117][118][119][120].…”

Section: • Dysgeusia or Ageusia;mentioning

confidence: 99%

Section: Pseudomembraneous Candidiasismentioning

confidence: 99%

Section: Erythematous Candidiasismentioning

confidence: 99%

See 2 more Smart Citations

HIV Infection and Oral Manifestations: An Update

Fonseca¹,

Laurentino²,

Machado³

et al. 2023

Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…Candida albicans is the most common causative agent of candidiasis infections in PLWH, and literature seems to indicate that strains isolated from HIV-positive individuals may be more virulent than in those who have immunocompetent immune systems. 2 Non-Candida albicans infections (Candida glabrata) have emerged as azole-resistant strains in those with refractory mucosal candidiasis and advanced immunosuppression. 1 Oropharyngeal candidiasis most often occurs when CD4 counts are <200 cells/ mm 3 ; however, esophageal candidiasis tends to occur at lower CD4 counts.…”

Section: Candidiasismentioning

confidence: 99%

Management of Common Opportunistic Infections in People Living With HIV

Fuller¹,

Bultas²

2022

The Journal for Nurse Practitioners

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Common Oral Conditions

Stoopler,

Villa,

Bindakhil

et al. 2024

JAMA

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ImportanceDry mouth, oral candidiasis, and recurrent aphthous ulcers are 3 of the most common oral conditions that may be associated with patient discomfort, decreased quality of life, and morbidity.ObservationsIn a meta-analysis of 26 population-based cohort and cross-sectional studies, the global prevalence of dry mouth symptoms was 23% (95% CI, 18% to 28%), placing individuals at risk of oral candidiasis, dental caries, dysgeusia, masticatory/speech impairment, and oropharyngeal dysphagia. Dry mouth is associated with using more than 3 oral medications per day (odds ratio [OR], 2.9 [95% CI, 1.4 to 6.2]), head and neck radiation, and Sjögren disease. Symptoms may include difficulty swallowing and speaking, thirst, and halitosis. Dry mouth is associated with an 11.5% (95% CI, 3.6% to 27%) higher risk of oral candidiasis, based on a meta-analysis of 6 observational cohorts. Management of dry mouth includes mechanical salivary stimulants, oral moisturizers, and/or systemic sialagogues. Oral candidiasis is an opportunistic fungal infection caused by overgrowth of the Candida genus with C albicans, which accounts for 76.8% of infections. The prevalence of oral candidiasis is higher in patients who are immunosuppressed, for example, those with HIV (35% [95% CI, 28% to 42%]) and those with salivary gland hypofunction (OR, 3.02 [95% CI, 1.73 to 5.28]). Common risk factors associated with oral candidiasis include use of antibiotics (P = .04) and oral mucosal disorders such as lichen planus. Oral burning and dysgeusia are common symptoms of oral candidiasis. Treatment includes addressing risk factors and use of topical and/or systemic antifungal medications. Recurrent aphthous stomatitis is characterized by symptomatic round or oval oral ulcers, which are covered by a gray-white fibrin layer and encircled by an erythematous ring. A meta-analysis of 10 case-controlled studies revealed an increased risk of recurrent aphthous stomatitis associated with polymorphism of IL-1β (+3954C/T) (OR, 1.52 [95% CI, 1.07 to 2.17]) and IL-1β (−511C/T) (OR, 1.35 [95% CI, 1.09 to 1.67]). Another meta-analysis of 9 case-control studies reported that patients with recurrent aphthous stomatitis had a higher frequency of nutritional deficiencies, including vitamin B12 (OR, 3.75 [95% CI, 2.38 to 5.94]), folic acid (OR, 7.55 [95% CI, 3.91 to 14.60]), and ferritin (OR, 2.62 [95% CI, 1.69 to 4.06]). Recurrent aphthous stomatitis can be associated with systemic diseases. A meta-analysis of 21 case-control studies revealed that celiac disease is associated with a higher incidence of recurrent aphthous stomatitis (25% vs 11%; OR, 3.79 [95% CI, 2.67 to 5.39]; P &lt;.001). Topical corticosteroids are first-line agents to manage recurrent aphthous stomatitis; however, systemic medications may be necessary in more severe cases.Conclusions and RelevanceDry mouth, oral candidiasis, and recurrent aphthous ulcers are common oral conditions that may be associated with patient discomfort, decreased quality of life, and morbidity. First-line treatment includes over-the-counter sialagogues for dry mouth, topical antifungals for oral candidiasis, and topical corticosteroids for aphthous ulcers. Oral conditions that do not improve with first-line treatment may require treatment with systemic medications.

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Are Candida albicans isolates from the oral cavity of HIV-infected patients more virulent than from non-HIV-infected patients? Systematic review and meta-analysis

Cited by 12 publications

References 46 publications

HIV Infection and Oral Manifestations: An Update

HIV Infection and Oral Manifestations: An Update

Management of Common Opportunistic Infections in People Living With HIV

Common Oral Conditions

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