Immunological and epidemiological factors affecting candidiasis in HIV patients beginning antiretroviral therapy in an Asian clinic
Autor: | Henny Saraswati, Samsuridjal Djauzi, Endah Ayu Tri Wulandari, Retno Wahyuningsih, Robiatul Adawiyah, Patricia Price |
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Rok vydání: | 2016 |
Předmět: |
0301 basic medicine
Adult Male Saliva medicine.medical_specialty beta-Defensins Adolescent Context (language use) Oral hygiene Oropharyngeal Candidiasis 03 medical and health sciences 0302 clinical medicine Candidiasis Oral Internal medicine Prevalence Medicine Humans Candida albicans General Dentistry biology AIDS-Related Opportunistic Infections business.industry Incidence (epidemiology) Case-control study 030206 dentistry Cell Biology General Medicine Middle Aged biology.organism_classification Corpus albicans stomatognathic diseases 030104 developmental biology nervous system Otorhinolaryngology Anti-Retroviral Agents Indonesia Case-Control Studies Immunology Female business |
Zdroj: | Archives of oral biology. 82 |
ISSN: | 1879-1506 |
Popis: | Objectives Oropharyngeal candidiasis (OPC) is common in HIV patients beginning antiretroviral therapy (ART). Here we address the response to ART, and the roles of poor oral hygiene and defects in local innate immunity with a focus on salivary β-defensins, as they are implicated in control of candidiasis but have not been investigated in this context. Design ART naive HIV-infected adults (n = 82) with + T-cells/mm 3 attending clinics at Cipto Mangunkusumo Hospital, Jakarta, were examined at the commencement of ART, and 73 were re-examined after 3 months. OPC was detected by clinical examination, and Candida albicans and fungal burdens were determined following culture on CHROMagar and saboroud-dextrose agar (resp). Salivary β-defensins (−2 and −3) were quantified by ELISA. Healthy control subjects (n = 40) matched the patients by age and gender. Results OPC was evident in 47 patients before ART, and associated with greater fingal burdens. No OPC was detected in healthy controls and culture positivity was rare. ART decreased the prevalence of OPC to 8/73 HIV patients re-examined after 3 months, with reduced total fungal and C. albicans burdens. The incidence of OPC was independent of oral hygiene. Hyposalivation was more common in untreated HIV patients (16%) than after 3 months on ART and was rare in healthy controls. HIV patients were also more likely to have acidic saliva. Salivary β-defensin-2 was elevated in the presence of C. albicans pseudohyphae and OPC after 3 months on ART, but β-defensin-3 was not affected by OPC or ART. Conclusions ART reduces the prevalence of OPC, and the total fungal and C. albicans burden. Levels of salivary β-defensin-2 may associate with OPC in HIV patients responding to ART. |
Databáze: | OpenAIRE |
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