Oral Candidiasis in HIV/AIDS                  Orient Journal of Medicine                   Vol 31 [1-2] Jan-June, 2019
ORIGINAL ARTICLE

Spectrum of Oral Candidiasis in HIV/AIDS: Treatment and Response to Various Antifungal Agents in a Tertiary Hospital in Abuja

Bob A UKONU1
Perpetua U IBEKWE1
Tahiru YUNUSA2
Vivan G KWAGHE1
Grace A OTOKPA1
Nkechi A OBIANOZIE1


1Department of Medicine University of Abuja Teaching Hospital Abuja, NIGERIA

2Department of Clinical Microbiology University of Abuja Teaching Hospital Abuja, NIGERIA


Author for Correspondence
Dr Bob Agwu UKONU
Department of Medicine University of Abuja Teaching Hospital Abuja, NIGERIA

Phone: +234-8037866885;
Email: bobify@yahoo.com
Received: December 1st, 2018 Accepted: February 5th, 2019


DISCLOSURE The authors declare no conflict of interest in this study. No external funding was received; the cost of the study was borne entirely the authors

ABSTRACT

Background: Oral candidiasis is one of the commonest opportunistic infections seen in people with Human Immunodeficiency Virus/Acquired Immune deficiency Syndrome (HIV/AIDS) infection. Although oral candidiasis can occur at any stage of HIV infection, it is more predominant in patients with declining CD4+ count. Majority of the candida isolates are Candida albicans and they are sensitive to topical/systemic antifungal agents such as fluconazole, itraconazole and oral nystatin.
Objective: This study seeks to identify the candida species implicated in oral candidiasis among HIV/AIDS patients and the response rate to various antifungal agents used in our facility.
Methodology: This is a prospective study of all HIV/AIDS infected patients admitted into our facility over a period of nine months (December 2016- August 2017) and were clinically diagnosed with oral candidiasis. A proforma was designed to capture their bio-data, symptoms such as burning sensations in the mouth, odynophagia, dysphagia and clinical types of oral candidiasis. Their CD4+ count, liver function test, full blood count, candida species isolation and their treatment response were noted and documented.
Results: Of the 312 HIV/AIDS infected patients admitted, 82(26.3%) had clinically diagnosed oral candidiasis. Candida albicans accounted for 79.3%, and Candida dubliniensis accounted for 7.3%. The mean CD4+ count was 94.4cells/l and 55.0% of those who had oral candidiasis responded to Itraconazole within seven days of therapy.
Conclusion: The most common specie isolated among HIV infected patients admitted at the University of Abuja Teaching Hospital was Candida albicans and its response to itraconazole was good even at a low CD4+ count.



Keywords:
Immunosuppression, Candidasis, CD4+count, Fluconazole, Itraconazole, Nyastin