Journal Article

Declining Rates of Oropharyngeal Candidiasis and Carriage of <i>Candida albicans</i> Associated with Trends Toward Reduced Rates of Carriage of Fluconazole-Resistant <i>C. albicans</i> in Human Immunodeficiency Virus—Infected Patients

Marcelo D. Martins, Mario Lozano-Chiu and John H. Rex

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 5, pages 1291-1294
Published in print November 1998 | ISSN: 1058-4838
Published online November 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515006
Declining Rates of Oropharyngeal Candidiasis and Carriage of Candida albicans Associated with Trends Toward Reduced Rates of Carriage of Fluconazole-Resistant C. albicans in Human Immunodeficiency Virus—Infected Patients

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In order to determine the current prevalence and incidence of fluconazole-resistant oropharyngeal candidiasis among human immunodeficiency virus (HIV)—infected patients, we conducted a prospective observational study of a consecutive series of HIV-infected patients. Of 128 enrolled patients, 70 patients completed four quarterly follow-up visits over a period of 1 year. Over this period, declining rates of carriage of Candida albicans (from 61% to 39%; P = .008) and of oropharyngeal candidiasis (from 30% to 4%; P < .001) were documented. Trends toward reduction in the frequency of fluconazole-resistant isolates (MIC, ⩾64 µg/mL) were also seen. During the survey period, the mean (median) number of antiretroviral agents used per patient rose from 0.5 (0) to 1.8 (2) (P < .001). Thus, rather than progression, we observed declining rates of oropharyngeal candidiasis, C. albicans carriage, and fluconazole-resistant C. albicans in a cohort of HIV-infected patients treated with increasingly effective antiretroviral therapy.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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