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Oropharyngeal candidiasis in the era of antiretroviral therapy
- Source :
- Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 109(4)
- Publication Year :
- 2009
-
Abstract
- Oropharyngeal candidiasis (OPC) remains a common problem in the HIV-infected population despite the availability of antiretroviral therapy (ART). Although Candida albicans is the most frequently implicated pathogen, other Candida spp. may also cause infection. The emergence of antifungal resistance within these causative yeasts, especially in patients with recurrent oropharyngeal infection or with long-term use of antifungal therapies, requires a working knowledge of alternative antifungal agents. Identification of the infecting organism and antifungal susceptibility testing enhances the ability of clinicians to prescribe appropriate antifungal therapy. Characterization of the responsible mechanisms has improved our understanding of the development of antifungal resistance and could enhance the management of these infections. Immune reconstitution has been shown to reduce rates of oropharyngeal candidiasis but few studies have evaluated the current impact of ART on the epidemiology of oropharyngeal candidiasis and antifungal resistance in these patients. Preliminary results from an ongoing clinical study showed that in patients with advanced AIDS oral yeast colonization was extensive, occurring in 81.1% of the 122 patients studied and symptomatic infection occurred in a third. In addition, resistant yeasts were still common occurring in 25.3% of patients colonized with yeasts or with symptomatic infection. Thus, oropharyngeal candidasis remains a significant infection in advanced AIDS even with ART. Current knowledge of the epidemiology, pathogenesis, clinical presentation, treatment, and mechanisms of antifungal resistance observed in oropharyngeal candidiasis are important in managing patients with this infection and are the focus of this review.
- Subjects :
- medicine.medical_specialty
Antifungal Agents
AIDS-Related Opportunistic Infections
Population
Oropharynx
HIV Infections
Drug resistance
Oropharyngeal Candidiasis
Article
Immunocompromised Host
Acquired immunodeficiency syndrome (AIDS)
Candidiasis, Oral
Drug Resistance, Fungal
Epidemiology
medicine
Humans
education
Candida albicans
General Dentistry
Mycosis
Candida
education.field_of_study
biology
Pharyngeal Diseases
medicine.disease
biology.organism_classification
Otorhinolaryngology
Anti-Retroviral Agents
Immunology
Surgery
Oral Surgery
Subjects
Details
- ISSN :
- 1528395X
- Volume :
- 109
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics
- Accession number :
- edsair.doi.dedup.....755a7a88ed183c0898f50d6dc157777c