Effect of prolonged HAART on oral colonization with Candidaand candidiasisReportar como inadecuado




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BMC Infectious Diseases

, 6:8

First Online: 20 January 2006Received: 07 July 2005Accepted: 20 January 2006

Abstract

BackgroundProgressive cell-mediated immunodeficiency with decrease of CD4+ lymphocyte count to less than or equal to 200 cells-mm is a major risk factor for colonization with Candida species and development of candidiasis. Oropharyngeal candidiasis may occur in up to 90% of human immunodeficiency virus HIV-infected patients during the course of the disease. This study is to determine the effect of prolonged highly active antiretroviral therapy HAART on oropharyngeal colonization with Candida species and oral candidiasis.

MethodsA prospective, longitudinal follow-up study in HIV-infected patients receiving HAART.

ResultsThe mean CD4+ count increased from 232.5 to 316 cells-mm and the proportion of patients whose CD4+ count less than 200 cells-mm decreased from 50.0% to 28.9% p = 0.0003 in patients receiving HAART for at least 2 years. The prevalence of oral candidiasis decreased from 10.6% to 2.1% p = 0.004. The decrease in Candida colonization was less impressive, falling from 57.8% to 46.5 % p = 0.06. Of the 142 patients enrolled in at least two surveys, 48 33.8% remained colonized with Candida and 42 29.6% remained negative. In the remaining 52 patients, 34 switched from culture positive to negative, and an increase in CD4+ lymphocytes was noted in 91.2% of them. Among the 18 patients who switched from culture negative to positive, 61.1% also demonstrated an increase in CD4+ lymphocyte count p = 0.01.

ConclusionThese findings indicate that HAART is highly effective in decreasing oral candidiasis in association with a rise in CD4+ lymphocyte counts, but only marginally effective in eliminating Candida from the oropharynx.

Abbreviations usedHIVhuman immunodeficiency virus

HAARThighly active antiretroviral therapy

AIDSacquired immune deficiency syndrome

NYUHNational Taiwan University Hospital

PVLPlasma viral RNA load

RT-PCRreverse transcriptase-polymerase chain reaction

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Autor: Yun-Liang Yang - Hsiu-Jung Lo - Chien-Ching Hung - Yichun Li

Fuente: https://link.springer.com/







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