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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

1
Faculty of Dentistry, Srinakharinwirot University, 114 Sukhumvit 23, Wattana, Klongtoey Nua, Bangkok 10110, Thailand.
2
Faculty of Dentistry, Rangsit University, 52/347 Phaholyothin Road, Mueang Pathum Thani District, Pathum Thani 12000, Thailand.
3
Faculty of Dentistry, Prince of Songkla University, 15 Karnjanavanich Raod, Hat Yai, Songkhla 90110, Thailand.

Abstract

Background:

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.

Results:

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.

Conclusions:

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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