A study of oral candidal carriage and cd4 t-lymphocyte count in hiv positive patients and antifungal susceptibility of isolated candidal strains for fluconazole and voriconazole in vitro

Objectives: To detect the prevalence of asymptomatic Candidal colonization among HIV positive and Healthy individuals and to investigate the relationship of asymptomatic Candidal colonization of oral cavity and CD4 T-lymphocyte count and to assess antifungal drug susceptibility for Candida species by Fluconazole and Voriconazole in vitro. Methods: Asymptomatic candidal Colonization of oral cavity were investigated in total 50 HIV positive patients having CD4T- lymphocyte count < 500 cells / cu. mm and absence of antifungal treatment at Acharya Vinoba Bhave Rural Hospital Wardha, India. Fifty healthy controls were selected to ensure comparability. Oral swabs were collected from tongue and palate, Candidal species isolated and antifungal susceptibility testing had conducted based on disk diffusion procedures. Results: Prevalence of Candidal colonization was 52% among the cases which was significantly higher than the healthy control(8%) (p=0.00001). There is no association between asymptomatic Candidal colonization on tongue and palate with decreasing CD4 T lymphocyte count statistically (P=0.3454, P=0.7279). Antifungal susceptibility, among cases, Candidal colonization, 78.8% and 71.1% were sensitive and 17.3% and 26.9 % were resistant to Fluconazole and Voriconazole respectively. Conclusions: High prevalence of Candidal colonization found among HIV positive individuals. Asymptomatic oral Candidal colonization is not related to CD4 T- lymphocyte count. Antifungal drug sensitivity must be done.