Clinical characteristics and management responses in 85 HIV-infected patients with oral candidiasis.

Abstract

Eighty-five consecutively seen HIV-positive persons with oral candidiasis were evaluated for clinical characteristics, staging of HIV disease, quantitation of candidal colony formation, and response to systemic antifungal treatment with Nizoral (ketoconazole). Fifty-five had CD4 counts less than 200. There was an inconsistent association between clinical signs, patient symptoms, CD4 counts, and candidal colony-forming units. However, there was a trend toward higher colony-forming unit counts (> 500) in patients with lower CD4 cells (< 200). Sixty-five patients had a complete clinical response to the ketoconazole treatment (200 mg daily for 7 days), even though 81% of posttreatment cultures remained positive. Nonsmokers were more likely to respond to antifungal treatment when compared with smokers, and there was a slight tendency for complete responses when colony-forming unit counts were low. The most common lesion presentation was a combination of the white (pseudomembranous) and red (erythematous) forms. Forty-nine percent had complaints of pain. The variable responses indicated the importance of flexible dose-time and drug considerations in antifungal management. Candida albicans was the predominant species.

• Authors: S Silverman Jr, J W Gallo, M L McKnight, P Mayer, S deSanz, M M Tan
• Journal: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics (Oral Surg Oral Med Oral Pathol Oral Radiol Endod) Vol. 82 Issue 4 Pg. 402-7 (Oct 1996) ISSN: 1079-2104 [Print] United States
• PMID: 8899777 (Publication Type: Journal Article)

Chemical References

• Antifungal Agents
• Ketoconazole

Topics

• AIDS-Related Opportunistic Infections (drug therapy, immunology, microbiology)
• Antifungal Agents (administration & dosage, therapeutic use)
• CD4 Lymphocyte Count
• Candidiasis, Oral (drug therapy, etiology, immunology, microbiology)
• Colony Count, Microbial
• Dose-Response Relationship, Drug
• Humans
• Ketoconazole (administration & dosage, therapeutic use)
• Smoking