Prevalence of oral disease among adults with primary HIV infection.
ABSTRACT To explore the type and prevalence of oral mucosal lesions among adults with primary HIV infection (PHI) compared with HIV-negative adults at high risk for HIV disease, and in relation to HIV viral load.
We conducted standardized oral examinations to identify specific oral mucosal lesions among adults with PHI, both pre-seroconversion and post- seroconversion-recently infected, compared with HIV-negative adults. We compared the group with oral lesions to those without oral lesions with respect to HIV-RNA load and CD4 + T-cell count.
Among 115 adults (predominantly men), pseudomembranous candidiasis was the most common oral lesion among those with PHI, and was found in 4% of the 23 participants in pre-seroconversion and in 9% of 69 participants with post-seroconversion recent infection, compared with none found among 23 HIV negatives. Among those with PHI, the median viral load was higher and the median CD4 + T-cell count lower among the 15 participants with an oral lesion of any type than among the 77 participants without oral lesions (P = 0.02 and 0.04, respectively).
This finding suggests that individuals with PHI who have oral lesions may be more likely to transmit HIV because of their higher viral load.
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ABSTRACT: There is paucity of information about the factors associated with oral colonization with Candida species and the changes with antiretroviral therapy in our study population. This study investigated the role of antiretroviral therapy and other factors. Relevant clinical and laboratory information was obtained and oral rinse specimens tested for yeast identification. Findings were compared with previous data from the same clinic before antiretroviral therapy was available. Of the 197 patients, 117 (59.4%) were colonized. Candida albicans was the most dominant species (71%) and Candida dubliniensis was the most frequent non-albicans Candida. The colonized group had a higher rate of concurrent tuberculosis infection (77.4% compared with 56% in the non colonized, P=0.03) and higher median CD4+ count, 418 cell/mm3, compared with the non-colonized group with 346.5 cell/mm3. Participants not on antiretroviral therapy and those having oral prosthesis were all colonized, P=0.003 and 0.022, respectively. Oral Candida count was negatively correlated with the CD4+ count in participants on antiretroviral therapy, P=0.006. Associated factors using logistic regression were dental caries (OR=1.30; 95%CI=1.07, 1.60;) and diabetes mellitus (OR=5.52; 95%CI=1.68, 18.12;). The colonization rate was higher (81.3%) and yeast count before antiretroviral therapy was available and the prevalence of C. dubliniensis has increased from 6.3% to 11%. Dental caries, diabetes mellitus, oral prostheses, and tuberculosis infection were associated with oral colonization. Colonization rate, variety and count of yeast have declined with antiretroviral therapy.Journal of Medical Microbiology 01/2013; 62:126-132. DOI:10.1099/jmm.0.047522-0 · 2.27 Impact Factor
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ABSTRACT: This study was designed to evaluate the in vitro antifungal activities of four traditional Chinese medicine (TCM) extracts. The inhibitory effects of pseudolaric acid B, gentiopicrin, rhein, and alion were assessed using standard disk diffusion and broth microdilution assays. They were tested against six oral Candida species, Candida albicans, Candida glabrata, Candida tropicalis, Candida krusei, Candida dubliniensis, and Candida guilliermondii, including clinical isolates from HIV-negative, HIV-positive, and Sjögren's syndrome patients. It was found that pseudolaric acid B had the most potent antifungal effect and showed similar antifungal activity to all six Candida spp, and to isolates from HIV-negative, HIV-positive, and Sjögren's syndrome patients. The MIC values ranged from 16 to 128 μg/mL. More interestingly, a synergistic effect of pseudolaric acid B in combination with fluconazole was observed. We suggest that pseudolaric acid B might be a potential therapeutic fungicidal agent in treating oral candidiasis.Evidence-based Complementary and Alternative Medicine 02/2012; 2012:106583. DOI:10.1155/2012/106583 · 2.18 Impact Factor
- Revista Cubana de Investigaciones Biomedicas 09/2013; 32(3):284-292.