Oral Candidosis in HIV-Infected Patients

Abstract

Oral candidosis (syn. Oral candidiasis; OC), is a collective term given to a group of oral mucosal disorders caused by the fugal pathogen belonging to the genus Candida. The association of OC with the human immunodeficiency virus (HIV) infection has been known since the advent of the acquired immune deficiency syndrome (AIDS) pandemic. OC is one of the earliest manifestations of HIV disease in high risk individuals not undergoing chemotherapy and is also a strong predictor of the subsequent risk of AIDS-related illness or death. With the advances in HIV therapy, such as highly active anti-retroviral therapy (HAART), the prevalence and presenting features of OC have changed in HIV-infected individuals, especially those in industrialized countries. The presence of OC in "controlled" HIV-positive individuals may be indicative of a patient nonadherence to therapy or possible failure. The factors contributing to the genesis of OC and its progression in these individuals are poorly understood, but may include an interrelationship between HIV and Candida and/or a dysfunction in the local immunity, superimposed on weakened cell-mediated immunity and depletion of CD4 T cells. The dramatic increase in publications on this topic matches the increased importance and awareness of this opportunistic infection in HIV-infected individuals. In this review we first address the epidemiologic and clinical features of OC in HIV-infected persons, followed by the current understanding of the pathogenesis of OC in the context of HIV infection with a concluding section on the current management concepts of OC.

Comparação do perfil de suscetibilidade entre isolados clínicos de Candida spp. orais e vulvovaginais no Sul do Brasil

“…são agentes comensais que colonizam a cavidade bucal de cerca de 30% a 35% da população adulta sem evidência de infecção. A candidía-se da mucosa oral apresenta formas clínicas variadas, como a candidíase pseudomembranosa, popularmente conhecida como sapinho, além das formas eritematosa, hiperplásica e mucocutânea (7) . Os principais fatores relacionados com a infecção oral são a síndrome da imunodeficiência adquirida (SIDA), a má-higiene de prótese dentária, os aparelhos ortodônticos e outras doenças imunossupressoras (15) .…”

Susceptibility of Candida albicans to photodynamic therapy in a murine model of oral candidosis

“…1,2 The predisposing factors of oral candidosis include immunocompromised states, diabetes mellitus, dental prostheses, xerostomia, 3,4 and prolonged use of antibiotics or immunosuppressive drugs. 5,6 With the advent of the human immunodeficiency virus (HIV) infection, increased attention has been paid to oral candidosis, because up to 90% of HIV-infected individuals suffer from oral Candida infection.…”

“…5,6 With the advent of the human immunodeficiency virus (HIV) infection, increased attention has been paid to oral candidosis, because up to 90% of HIV-infected individuals suffer from oral Candida infection. 3 The widespread use of topical and systemic antifungal agents as conventional treatment for oral candidosis has resulted in the development of resistance in C. albicans. 7 Although resistance of C. albicans to polyenes is rare, several mechanisms of azole resistance 8 have been reported, including changes in the cell wall or plasma membrane, which lead to impaired azole uptake; overexpression of or mutations in the target enzyme of azoles; and the efflux of drugs mediated by membrane transport proteins.…”

Disinfectant Efficacy of 0.525% Sodium Hypochlorite and Epimax on Alginate Impression Material

“…The British Dental Association in its advice sheet A12 recommended disinfection and decontamination of dental impressions. 3 Studies have proved the efficacy of tap water between 50 and 90% in eliminating microorganisms. Most of the dentists prefer phenols, alcohols, chlorine combination, aldehydes, biguanides, iodide, etc., as disinfecting agents.…”