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Oral colonization by Candida species and associated factors in HIV-infected patients in Ahvaz, southwest Iran
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Elham Aboualigalehdari, Maryam Tahmasebi Birgani, Mahnaz Fatahinia, Mehran Hosseinzadeh
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Epidemiol Health. 2020;42:e2020033. Published online May 24, 2020
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DOI: https://doi.org/10.4178/epih.e2020033
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Abstract
Objectives
Oropharyngeal candidiasis is one of the most common opportunistic fungal infections among human immunodeficiency virus (HIV)-infected individuals. The most common cause is <i>Candida albicans</i>, followed by non-<i>albicans Candida</i>. This study aimed to identify colonized <i>Candida</i> species in HIV-infected patients from Ahvaz, Iran. Additionally, the relationships between immunity-related factors, lifestyle, and colonization of <i>Candida</i> spp. were studied.
Methods Oral swabs were taken from 201 HIV-positive patients referred for consultations at the Behavioral Modification Center. Oral <i>Candida</i> colonization was detected using culture-based and molecular assays. Data were assessed by descriptive statistics and analyzed to investigate the correlation between <i>Candida</i> colonization and various factors, including the CD4<sup>+</sup> cell count and viral load.
Results It was found that 43.8% of patients were positive for <i>Candida</i>. The most common species was C. <i>albicans</i> (48.0%), followed by non-<i>albicans Candida</i> isolates, including <i>C. dubliniensis, C. glabrata, C. tropicalis, C. parapsilosis, C. guilliermondii, C. kefyr</i>, and <i>C. krusei.</i> Colonization of <i>Candida</i> spp. in patients was associated with a CD4 count ≤200 cells/mm<sup>3</sup> (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. <i>albicans</i> was the dominant pathogen. The risk factors for colonization of <i>Candida</i> spp. were a CD4 count ≤ 200/mm<sup>3</sup> , a history of shared injections, and sex. Other factors with potential relationships include viral load, age, and opportunistic infections, but further investigations are needed.
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Summary
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Citations
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