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. 2020:42:e2020033.
doi: 10.4178/epih.e2020033. Epub 2020 May 24.

Oral colonization by Candida species and associated factors in HIV-infected patients in Ahvaz, southwest Iran

Elham Aboualigalehdari  1 , Maryam Tahmasebi Birgani  2 , Mahnaz Fatahinia  1   3 , Mehran Hosseinzadeh  4
Affiliations

Oral colonization by Candida species and associated factors in HIV-infected patients in Ahvaz, southwest Iran

Elham Aboualigalehdari et al. Epidemiol Health. 2020.

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 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/mm3 (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/mm3 , a history of shared injections, and sex. Other factors with potential relationships include viral load, age, and opportunistic infections, but further investigations are needed.

Keywords: Candidiasis; Colonization; Human immunodeficiency virus; Iran; Oral; Species.

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Conflict of interest statement

The authors have no conflicts of interest to declare for this study.

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