Factors Associated with Oral Candidiasis in People Living with HIV/AIDS: A Case Control Study

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Abstract

Background

Oral candidiasis (OC) is the most frequent opportunistic infection of the oral cavity caused by Candida species overgrowth. A wide variety of risk factor that contributes to yeast infection especially candidiasis. It might be acting as an early marker for people living with HIV/AIDS (PLWHA). There are some risk factors for PLWHA associated OC at Wangaya hospital in Denpasar, Bali, Indonesia.

Aim

To identify risk factors of OC in PLWHA at Wangaya Hospital in Denpasar, Bali, Indonesia.

Settings and Design

Case control study was conducted from March 1, 2016 and July 30, 2019, included 448 participants (207 cases and 241 controls). Consecutive recruitment was employed.

Methods

Cases were PLWHA (18 to 60 years old) with OC and controls without OC. Diagnosis of OC based on the clinical features which are the pseudomembranous candidiasis; oral thrush. An interviewer administered a structured questionnaire used to collect information on risk factors. Statistical analysis used: bivariate analysis was performed on all variables. Chi-square test with statistically significant was at a level of 0.05.

Results

The participants included 207 (46.20%) PLWHA with OC and 241 (53.80%) PLWHA who did not have OC. The majority participants, 293 (65.40%) were male. OC was associated with age [p = 0.03; OR = 0.66 (95% CI:0.45–0.95)]; sex [p = 0.002; OR = 1.88 (95% CI:1.26–2.80)]; Xerostomia [p = 0.000; OR = 4.15 (95% CI:2.76–6.23)]; smoking [p = 0.000; OR = 6.83 (95% CI: 4.46–10.44)]; alcohol consumption [p = 0.000; OR = 5.76 (95% CI: 3.74–8.83)]; antibiotic usage [p = 0.000; OR = 4.49 (95% CI: 2.93–6.90)]; CD4 count [p = 0.000; OR = 3.29 (95% CI:2.24–4.86)]; HIV clinical stage [p = 0.000; OR = 3.58 (95% CI 2.39–5.37)]. No significant association between prothesis with OC.

Conclusion

We found that age, sex, xerostomia, smoking, alcohol consumption, antibiotic usage, CD4 counts and advanced HIV Clinical stage (AIDS) were significant associated risk factors for OC in PLWHA.

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Most cited references 38

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Xerostomia: etiology, recognition and treatment.

James Guggenheimer, Paul Moore (2003)

Clinicians may encounter symptoms of xerostomia, commonly called "dry mouth," among patients who take medications, have certain connective tissue or immunological disorders or have been treated with radiation therapy. When xerostomia is the result of a reduction in salivary flow, significant oral complications can occur. The authors conducted an Index Medicus--generated review of clinical and scientific reports of xerostomia in the dental and medical literature during the past 20 years. The literature pertaining to xerostomia represented the disciplines of oral medicine, pathology, pharmacology, epidemiology, gerodontology, dental oncology, immunology and rheumatology. Additional topics included the physiology of salivary function and the management of xerostomia and its complications. Xerostomia often develops when the amount of saliva that bathes the oral mucous membranes is reduced. However, symptoms may occur without a measurable reduction in salivary gland output. The most frequently reported cause of xerostomia is the use of xerostomic medications. A number of commonly prescribed drugs with a variety of pharmacological activities have been found to produce xerostomia as a side effect. Additionally, xerostomia often is associated with Sjögren's syndrome, a condition that involves dry mouth and dry eyes and that may be accompanied by rheumatoid arthritis or a related connective tissue disease. Xerostomia also is a frequent complication of radiation therapy. Xerostomia is an uncomfortable condition and a common oral complaint for which patients may seek relief from dental practitioners. Complications of xerostomia include dental caries, candidiasis or difficulty with the use of dentures. The clinician needs to identify the possible cause(s) and provide the patient with appropriate treatment. Remedies for xerostomia usually are palliative but may offer some protection from the condition's more significant complications.

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Current treatment of oral candidiasis: A literature review

Carla Garcia-Cuesta, Maria-Gracia Sarrion-Pérez, Jose V. Bagan (2014)

Candidiasis or oral candidosis is one of the most common human opportunistic fungal infections of the oral cavity. This pathology has a wide variety of treatment which has been studied until these days. The present study offers a literature review on the treatment of oral candidiasis, with the purpose of establish which treatment is the most suitable in each case. Searching the 24 latest articles about treatment of candidiasis it concluded that the incidence depends on the type of the candidiasis and the virulence of the infection. Although nystatin and amphotericin b were the most drugs used locally, fluconazole oral suspension is proving to be a very effective drug in the treatment of oral candidiasis. Fluconazole was found to be the drug of choice as a systemic treatment of oral candidiasis. Due to its good antifungal properties, its high acceptance of the patient and its efficacy compared with other antifungal drugs. But this drug is not always effective, so we need to evaluate and distinguish others like itraconazole or ketoconazole, in that cases when Candida strains resist to fluconazole. Key words:Candidiasis, treatment, miconazole, fluconazole, nystatin.

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Smoking and HIV: prevalence, health risks, and cessation strategies.

H Lando, Alan R Lifson (2012)

Health hazards due to smoking may undermine benefits of HIV treatment on morbidity and mortality. Over 40% of persons with HIV are current smokers. Health risks of smoking include increases in some HIV-associated infections, cardiovascular disease, some cancers, bacterial pneumonia and other lung disease, and overall mortality. Proven strategies for smoking cessation include various counseling approaches, nicotine replacement therapy and other pharmacotherapy; approaches may need to be individualized to address specific client needs and comorbidities. HIV clinicians and other service providers can have an influential role in screening their patients for smoking and promoting cessation programs to improve health.

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Author and article information

Journal

Journal ID (nlm-ta): HIV AIDS (Auckl)

Journal ID (iso-abbrev): HIV AIDS (Auckl)

Journal ID (publisher-id): HIV

Journal ID (pmc): hiv

Title: HIV/AIDS (Auckland, N.Z.)

Publisher: Dove

ISSN (Electronic): 1179-1373

Publication date (Electronic): 14 January 2020

Publication date Collection: 2020

Volume: 12

Pages: 33-39

Affiliations

[1 ]Department of Internal Medicine, Wangaya Hospital of Denpasar , Bali, Indonesia

[2 ]Department of Biochemistry, Veterinary Faculty of Udayana, University of Denpasar , Bali, Indonesia

Author notes

Corespondence: Ketut Suryana Akasia Street, Lane.VIII No. 22 Denpasar, Bali80235, IndonesiaTel +62 859 537 839 44 Email ketutsuryana@gmail.com

Author information

Ketut Suryana http://orcid.org/0000-0003-4465-1705

Article

Publisher ID: 236304

DOI: 10.2147/HIV.S236304

PMC ID: 6969700

PubMed ID: 32021484

SO-VID: 49fd7608-9794-4231-bdc9-b32097657c7d

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

History

Date received : 28 October 2019

Date accepted : 20 December 2019

Page count

Tables: 2, References: 42, Pages: 7

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Factors Associated with Oral Candidiasis in People Living with HIV/AIDS: A Case Control Study

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Abstract

Background

Aim

Settings and Design

Methods

Results

Conclusion

Related collections

HIV Self-Testing

Most cited references 38

Xerostomia: etiology, recognition and treatment.

Current treatment of oral candidiasis: A literature review

Smoking and HIV: prevalence, health risks, and cessation strategies.

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Cited by 13

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