Virulence factors and genetic variability of vaginal Candida albicans isolates from HIV-infected women in the post-highly active antiretroviral era

Zanni, Pâmela Cristina Mastellaro Delvas; Mendonca, Patricia; Negri, Melyssa; Nakamura, Sandra Sayuri; Donatti, Lucélia; Svidzinski, Terezinha Inez Estivalet; Consolaro, Márcia Edilaine Lopes

doi:10.1590/s1678-9946201759044

Cited by 13 publications

(12 citation statements)

References 37 publications

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“…Previously conducted studies have shown that the increased vaginal colonization with fungi is caused by a loss of immunoprotective mechanisms 37,38 . In addition, proteinase activity, which plays an important role in the pathogenesis of VVC, is increased in HIV‐positive women and therefore renders them susceptible to VVC 39 . We hypothesize that these factors may explain the increased incidence of VVC in the HIV‐positive group compared with those in the control group.…”

Section: Discussionmentioning

confidence: 85%

HIV infection as a risk factor for vaginal dysbiosis, bacterial vaginosis, and candidosis in pregnancy: A matched case‐control study

Foessleitner

Petricevic

Boerger

et al. 2021

Birth

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Background This study aimed to evaluate the vaginal microbiota of HIV‐positive pregnant women relative to HIV‐negative controls, and to compare their risk of vaginal dysbiosis, bacterial vaginosis, and vulvovaginal candidosis (VVC). Methods This is a nested matched case‐control study that analyzed data from women who received pregnancy care at our center from 2003 to 2014. Women routinely underwent screening for asymptomatic vaginal infections using phase microscopy on Gram‐stained smears. HIV‐positive women were assigned to the case group, and HIV‐negative women were assigned to the control group. Cases and controls were matched in a 1:4 ratio. Logistic regression was used to test whether HIV infection was associated with vaginal dysbiosis (Nugent score 4‐6), BV (Nugent score 7‐10), or VVC. Results One hundred and twenty‐seven women were assigned to the case group, and 4290 were assigned to the control group (including 508 matched controls). Dysbiosis or BV was found in 29.9% of the cases and 17.6% of the controls. Women in the case group had increased risk of vaginal dysbiosis or BV (odds ratio [OR] 2.09, 95% confidence interval [CI], 1.30‐3.32, P = .002). The risk of VVC was also higher in the case group (OR 2.14, 95% CI, 1.22‐3.77, P = .008). The incidence of preterm birth did not differ significantly between the groups (cases: 8.7%; controls: 10%, P = .887). Conclusions HIV‐positive women are at risk of vaginal dysbiosis, BV, and VVC during pregnancy. As imbalances of the vaginal microbiota can lead to preterm birth, screening and treatment of HIV‐positive pregnant women are warranted.

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Section: Discussionmentioning

confidence: 85%

HIV infection as a risk factor for vaginal dysbiosis, bacterial vaginosis, and candidosis in pregnancy: A matched case‐control study

Foessleitner

Petricevic

Boerger

et al. 2021

Birth

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“…However, some strains of C. albicans, CP032012.1_410937; CP032012.1_398379, and C. dubliniensis, CR380958.2_1447277, were not found to be clustered within the same specified clade of their species. This observation may be due to the high variability witnessed in this genus which seems to be extremely distinctive as in such cases (28,29).…”

Section: Discussionmentioning

confidence: 98%

Identification of Candida Species Using 26S Ribosomal RNA Gene Sequencing in Patients with Periodontitis

2019

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“…As suggested by Thomas et al 32 and Ribeiro et al 33 , this difference could be explained by the use of protease inhibitors in HAART. Nevertheless, other authors posit that the presence of protease inhibitors in HAART does not affect the production of this enzyme [34][35][36] .…”

Section: Discussionmentioning

confidence: 99%

Enzyme production by Candida albicans and Candida dubliniensis in periodontal HIV-positive patients receiving and not receiving antiretroviral therapy.

Dubois¹,

González²,

Martı́nez³

et al. 2020

Acta Odontol Latinoam

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Candida dubliniensis (Cd) and Candida albicans (Ca) are the most frequently isolated yeasts in HIV+ patients. Some of the enzymes produced by these yeasts are considered virulence factors since they contribute to pathogenicity of Candida spp. The aim of the present study was to compare production of enzymes such as phospholipase (Ph), proteinase (P), and hemolysin (H) by Cd and Ca strains isolated from periodontal HIV-positive patients receiving and not receiving highly active antiretroviral therapy (HAART). Subgingival biofilm samples were obtained using paper points, and a sample of oral mucosa was taken using a swab. Phenotypic and molecular methods were used to isolate 39 strains of Candida, including 25 strains of Cd and 14 strains of Ca, obtained from 33 periodontal pocket samples and 6 oral mucosa samples collected from 15 HIV+ patients (8 receiving and 7 not receiving HAART). Malt egg-yolk agar, albumin agar and blood agar were used to evaluate pH, P and H production respectively. The strains were inoculated in duplicate and incubated at 37 ºC. Colony and halo diameters were measured. A greater proportion of Ca was observed in patients not receiving HAART, and a higher proportion of Cd was observed in those under HAART, Chi2 p< 0.001. Phospholipase production was observed in 92.9% percent of isolated Ca strains but in none of the isolated Cd strains. Proteinase production was high in Ca and Cd strains isolated from patients not receiving HAART. Hemolysin production was observed in all the studied strains, though it was significantly higher (p=0.04) in Ca and Cd strains isolated from patients not receiving HAART. To sum up, the proportion of Candida dubliniensis strains was highest in the subgingival biofilm of patients receiving HAART, and Cd strains were found to express fewer virulence factors than Ca strains.

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Virulence factors and genetic variability of vaginal Candida albicans isolates from HIV-infected women in the post-highly active antiretroviral era

Cited by 13 publications

References 37 publications

HIV infection as a risk factor for vaginal dysbiosis, bacterial vaginosis, and candidosis in pregnancy: A matched case‐control study

HIV infection as a risk factor for vaginal dysbiosis, bacterial vaginosis, and candidosis in pregnancy: A matched case‐control study

Identification of Candida Species Using 26S Ribosomal RNA Gene Sequencing in Patients with Periodontitis

Enzyme production by Candida albicans and Candida dubliniensis in periodontal HIV-positive patients receiving and not receiving antiretroviral therapy.

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