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J Clin Exp Dent. 2019 Feb 1;11(2):e138-e145. doi: 10.4317/jced.55384. eCollection 2019 Feb.

Oral manifestations, salivary flow rates and Candida species in Thai HIV-infected patients.

Author information

Faculty of Dentistry, Srinakharinwirot University, 114 Sukhumvit 23, Wattana, Klongtoey Nua, Bangkok 10110, Thailand.
Faculty of Dentistry, Rangsit University, 52/347 Phaholyothin Road, Mueang Pathum Thani District, Pathum Thani 12000, Thailand.
Faculty of Dentistry, Prince of Songkla University, 15 Karnjanavanich Raod, Hat Yai, Songkhla 90110, Thailand.



Effects of various Highly Active Antiretroviral Therapy (HAART) regimens on oral heath are unclear. Objectives: We aimed to evaluate effects of HAART on oral manifestations, salivary flow rates (SFR) and Candida species in HIV-infected patients who took mostly non-protease inhibitor-based HAART regimens.

Material and Methods:

A cross-sectional study was performed on HIV-infected patients taking and never taken HAART who attended Thai Red Cross AIDS Research Centre (n = 48). Non-HIV subjects were recruited as control (n = 20). Oral conditions and salivary flow rates were evaluated using oral examination and measurement of unstimulated and stimulated saliva. In addition, Candida colonization counts (colony forming units; CFUs) and Candida species from the collected saliva were evaluated using CHROMagar.


The most common oral manifestation in HIV-infected subjects taking HAART was hyperpigmentation. Unstimulated and stimulated SFR among the three groups were not statistically significant. Candida colonization was detected in 64%, 65% and 35% of HIV-infected subjects taking HAART, HAART-naïve, and non-HIV subjects, respectively. While 20% and 35% of HIV-infected subjects with and without HAART, respectively, had Candida CFUs higher than 500/ml, all non-HIV carriers had Candida CFUs lower than 500/ml. The most common Candida colonization species was C. albicans in HAART and non-HIV groups. Interestingly, HAART-naïve group was colonized more by non-albicans species.


HAART has minimal effects on oral health. While HAART may not prevent Candida colonization, it might lead to reduction of non-albicans species. Because maintaining low Candida counts is important, HAART administration and antifungal sensitivity test should be considered in HIV-infected patients. Key words:HIV, Candida, HAART, Oral manifestation, Salivary flow rates.

Conflict of interest statement

Conflict of interest statement:The authors declare that there is no conflict of interest.

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