A Comparative Evaluation of Oral Candida Carriage in HIV-Infected individuals and HIV Seronegative Healthy individuals in North Karnataka

Aim: Candida is one of the most common opportunistic fungi in HIV/AIDS cases. A detailed knowledge about oral candida carriage in HIV seropositive individuals is of paramount importance in the treatment of Oral Candidiasis (OC). In the present work, our aim was to determine and compare the candida carriage rate both in HIV infected and HIV non-infected healthy individuals along with knowing the species diversity of candida in HIV infected with OC and without OC and HIV non-infected healthy individuals. Methods: A total of 274 HIV seropositive individuals formed the test group. Test population was further grouped as Group 1 (HIV seropositive subjects with OC) comprising of 112 cases and Group 2 (HIV seropositive subjects without OC) comprising of 162 cases. The control group included 260 HIV seronegative healthy individuals.Concentrated oral rinse method was used to collect the specimen. Samples were inoculated on Sabouraud’s Dextrose Agar (SDA) and candida isolates were speciated by standard techniques.Statistical analysis of the data was done using Chi-square test and unpaired ‘t’ test methods. Results: HIV infected individuals with OC showed highest rate of candida carriage (97.32%). Rate of candida carriage in HIV seropositive individuals without OC (53.70%) was significantly more (p<0.001) compared to HIV seronegative healthy individuals (33.07%). In all the groups Candida albicans was the most commonly isolated species (73.48%). Conclusions: Increase in the oral candida carriage in HIV seropositive individuals may be due to immunosuppression. A few NAC spp. show high degree of resistance to commonly used antifungal. Therefore. it is essential to speciate candida isolates from HIV infected individuals. KEY-WORDS: Oral candida carriage, HIV infection, C. albicans, Oral Candidiasis. 1.INTRODUCTION Candida is a commensal of the gastrointestinal tract and oral mucosa is the most frequent site of colonization. Colonization by this organism can lead to clinically evident infections in the presence of various predisposing factors [1-3]. Oral candidiasis (OC) is one of the most common infections seen in HIV infected patients. Most of the clinical infections are endogenously derived from colonizing candida in oral mucosa. Thus colonization of the oral cavity with candida is important in the subsequent culmination into oral or esophageal candidiasis [1, 4, 5]. It is observed that subjects are usually persistently colonized with a single strain, despite of antifungal treatment [6, 7]. Studies have shown that the rate of oral candida carriage increases with advancing HIV infection. It is also reported that CD4 lymphocyte counts below 200 cells/mm, is a risk factor for development of OC in HIV infected individuals [8-10]. Though several species of candida can colonize the oral cavity, Candida albicans is the most commonly isolated species in both healthy and HIV infected individuals [8, 9, 11]. Wide spread use of fluconazole has led to, increased occurrence of resistant strains of C. albicans in various specimens and increased prevalence of Non Albicans Candida (NAC) species especially in HIV infected individuals [12-17]. Though studies on oral candida carriage in HIV seropositive individuals are available from India, studies on asymptomatic oral candida carriage in HIV infected individuals Pavithra Amrath Jain etal ,J Biosci Tech, Vol 2 (2),2011,232-237 ISSN:0976-0172 Journal of Bioscience And Technology