Article

Oral Candidosis in HIV-Infected Patients

Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita City, Osaka 565-0871, Japan.
Current HIV research (Impact Factor: 1.76). 12/2008; 6(6):485-99. DOI: 10.2174/157016208786501445
Source: PubMed

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.

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Available from: Lakshman P. Samaranayake
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    • "Human immunodeficiency virus (HIV) infection leads to a progressive loss of CD4+ T cell numbers and function, impairing immune responses and rendering the host susceptible to secondary opportunistic infections123. Opportunistic infections (OI) of the oral mucosa are presented in up to 80% of HIV-infected patients [4], often causing debilitating lesions that contribute to deterioration in nutritional health. "
    [Show abstract] [Hide abstract] ABSTRACT: Opportunistic oral infections can be found in over 80% of HIV + patients, often causing debilitating lesions that also contribute to deterioration in nutritional health. Although appreciation for the role that the microbiota is likely to play in the initiation and/or enhancement of oral infections has grown considerably in recent years, little is known about the impact of HIV infection on host-microbe interactions within the oral cavity. In the current study, we characterize modulations in the bacterial composition of the lingual microbiome in patients with treated and untreated HIV infection. Bacterial species profiles were elucidated by microarray assay and compared between untreated HIV infected patients, HIV infected patients receiving antiretroviral therapy, and healthy HIV negative controls. The relationship between clinical parameters (viral burden and CD4+ T cell depletion) and the loss or gain of bacterial species was evaluated in each HIV patient group. In untreated HIV infection, elevated viremia was associated with significantly higher proportions of potentially pathogenic Veillonella, Prevotella, Megasphaera, and Campylobacter species in the lingual microbiome than observed in healthy controls. The upsurge in the prevalence of potential pathogens was juxtaposed by diminished representation of commensal Streptococcus and Veillonella species. Colonization of Neisseria flavescens was lower in the lingual microbiome of HIV infected patients receiving antiretroviral therapy than in uninfected controls. Our findings provide novel insights into the potential impact of HIV infection and antiretroviral therapy on the community structure of the oral microbiome, and implicate potential mechanisms that may increase the capacity of non-commensal species to gain a stronger foothold.
    Full-text · Article · Jul 2012 · BMC Microbiology
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    • "These are opportunistic pathogens that can be spread and transferred through the oral cavity [18]. Candida causes common opportunistic infections known as oral candidiasis found in patients with immune deficiency [19]. Pseudomonas aeruginosa is a deadly infectious agent that exists epidemically on hospital instrument [18]. "
    [Show abstract] [Hide abstract] ABSTRACT: Introduction. The aim of this study was to investigate the effect of three different types of disinfectant agents on alginate impression material after 5 and 10 minutes. Method and Materials. In this in vitro experimental study, 66 circular samples of alginate impression material were contaminated with Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans fungus. Except for control samples, all of them were disinfected with sodium hypochlorite 0.525, Deconex, and Epimax by way of spraying. Afterwards, they were kept in plastic bags with humid rolled cotton for 5 and 10 minutes. The number of colonies was counted after 24 and 48 hours for bacteria and after 72 hours for fungus. Statistical Mann-Whitney test was used for data analysis (α = 0.05). Results. After 5 minutes, Epimax showed the highest disinfection action on Staphylococcus aureus as it completely eradicated the bacteria. The disinfection capacity of different agents can be increased as time elapses except for Pseudomonas aeruginosa which was eradicated completely in both 5 and 10 minutes. Conclusion. This study revealed that alginate can be effectively disinfected by three types of disinfecting agents by spraying method, although Epimax showed the highest disinfection action after 10 minutes compared to other agents.
    Full-text · Article · Jul 2012
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    • "However many examples of facilitation can be found in the literature. HIV and oral candidiasis is potentially a good example of one-way facilitation [23]. Candida albicans, the fungus that causes oral candidiasis, is a commensal in the normal human oral mucosa. "
    [Show abstract] [Hide abstract] ABSTRACT: Host individuals are often infected with more than one parasite species (parasites defined broadly, to include viruses and bacteria). Yet, research in infection biology is dominated by studies on single-parasite infections. A focus on single-parasite infections is justified if the interactions among parasites are additive, however increasing evidence points to non-additive interactions being the norm. Here we review this evidence and theoretically explore the implications of non-additive interactions between co-infecting parasites. We use classic Lotka-Volterra two-species competition equations to investigate the within-host dynamical consequences of various mixes of competition and facilitation between a pair of co-infecting species. We then consider the implications of these dynamics for the virulence (damage to host) of co-infections and consequent evolution of parasite strategies of exploitation. We find that whereas one-way facilitation poses some increased virulence risk, reciprocal facilitation presents a qualitatively distinct destabilization of within-host dynamics and the greatest risk of severe disease.
    Full-text · Article · Jun 2012 · PLoS ONE
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