Oral Colonization by Candida Species and Associated Factors among HIV-infected Patients in Ahvaz, Southwest Iran

Abstract

Oropharyngeal candidiasis is one of the most common opportunistic fungal infections among human immunodeficiency virus (HIV)-infected individuals. The most common cause is Candida albicans, followed by non-albicans Candida. This study aimed to identify colonized Candida species in HIV-infected patients from Ahvaz, Iran. Additionally, the relationships between immunity-related factors, lifestyle, and colonization of Candida spp. were studied. METHODS: Oral swabs were taken from 201 HIV-positive patients referred for consultations at the Behavioral Modification Center. Oral Candida colonization was detected using culture-based and molecular assays. Data were assessed by descriptive statistics and analyzed to investigate the correlation between Candida colonization and various factors, including the CD4 + cell count and viral load. RESULTS: It was found that 43.8% of patients were positive for Candida. The most common species was C. albicans (48.0%), followed by non-albicans Candida isolates, including C. dubliniensis, C. glabrata, C. tropicalis, C. parapsilosis, C. guilliermondii, C. kefyr, and C. krusei. Colonization of Candida spp. in patients was associated with a CD4 count ≤200 cells/mm 3 (odds ratio [OR], 4.62; p<0.05), history of shared injections (OR, 6.96; p<0.001), and sex (OR, 3.59; p<0.05). CONCLUSIONS: The results of this study showed that C. albicans was the dominant pathogen. The risk factors for colonization of Candida spp. were a CD4 count ≤ 200/mm 3 , a history of shared injections, and sex. Other factors with potential relationships include viral load, age, and opportunistic infections, but further investigations are needed.

Transcription Factors of CAT1, EFG1, and BCR1 Are Effective in Persister Cells of Candida albicans-Associated HIV-Positive and Chemotherapy Patients

“…Aging, uncontrolled diabetes mellitus, broadspectrum antibiotics, corticosteroid, and/or immunosuppressant drug use are predisposing factors for this disease. It acts also as a prognostic marker for systemic diseases such as diabetes mellitus and a common problem in immunocompromised patients such as HIV patients and those undergoing chemotherapy (Aboualigalehdari et al, 2013(Aboualigalehdari et al, , 2020Taff et al, 2013;Cavalheiro and Teixeira, 2018;Putranti et al, 2018).…”

Epidemiology, prevalence, and associated factors of oral candidiasis in HIV patients from southwest Iran in post-highly active antiretroviral therapy era

“…Oral candidiasis is an immunological state marker of HIVpositive patients and therefore represents a clinical predictor of HIV infection progression (Suryana et al, 2020). However, limited investigations in Iran have examined the prevalence of Candida species and associated factors in the oral cavity of HIV infected individuals (Ayatollahi Mousavi et al, 2012;Sharifzadeh et al, 2013;Khedri et al, 2018;Aboualigalehdari et al, 2020). In this survey, OC affected 41% of patients.…”

“…Under the auspices of Ahvaz Jundishapur University of Medical Sciences in southwest Iran, BDCC provides free services to PLWHA in the field of counseling, HIV/AIDS diagnosis, harm reduction, care and treatment. The sample size was calculated by assuming an expected prevalence (p) of 43.78% from the previous study of Aboualigalehdari et al (2020) with 95% confidence using the following formula: size was computed as 267. Eventually, information from 276 individuals with HIV was included in the study.…”

“…The reaction contained 12.5 µL of 2X master mix (Amplicon), 0.5 µL of each primer (10 µM), 3 µl of DNA template and PCR-grade water to make a final reaction volume of 25 µl. Duplex PCR cycles included initial denaturation at 95 • C for 5 min, 35 cycles of denaturation at 95 • C for 30 s, annealing at 56 • C for 45 s, extension at 72 • C for 1 min, with a final extension step of 5 min at 72 • C. The PCR product sizes of ∼100 bp and a ∼325 bp were identical to C. albicans and C. dubliniensis, respectively (Aboualigalehdari et al, 2020;Farahyar et al, 2020).…”

An update on human immunodeficiency virus and dentistry

“…Kaposi's sarcoma (KS) is an angioproliferative mesenchymal angioproliferative neoplasm caused by the herpes virus [43,44] , which develops most frequently in HIV-infected individuals [45] . Oropharyngeal candidiasis is one of the most common opportunistic fungal infections among persons infected with human immunodeficiency virus (HIV) [46] . In patients with HIV infection, fungal diseases can cause ulceration in the oral cavity, [47] however, few studies of Candida-associated oral ulcerative lesions have been performed in patients without HIV infection [48] .…”