Study of candida colonization and speciation in hiv-positive patients in a tertiary care hospital

Background: Progressive cell-mediated immunodeficiency with decrease of CD4+ lymphocyte count to less than or equal to 200 cells/mm3 is a major risk factor for colonization with Candida species and development of candidiasis. This study was done to investigate Candida colonization, speciation and their correlation with CD4+ cell counts in HIV-positive patients on antiretroviral therapy (ART) Methodology: A prospective, cross sectional study in HIV-infected patients receiving ART In total, 500 HIV-positive patients on ART treatment and 100 seronegative controls were enrolled in the study. All HIV patients underwent clinical examination and were subjected to CD4+ cell counts. Oral rinse samples were obtained and processed. Identification of Candida species was performed by conventional methods. Results: In the study group of 500, 166 (33.3%) had Candida colonization and were culture positive and in 100 healthy controls 25 (25%) of these indivduals were culture positive. Candida species were isolated in 166/500(33%) and 25/100 (25%) of the HIV-positive subjects and controls respectively. Candida albicans was the most frequently isolated species. Patients with CD4+ cell counts ≤ 200 cells/mm3 were significantly (p<0.0001) more frequently colonized 39/70(56%). Conclusion: Candida colonizationoccur more frequently in HIV-positive patients with CD4+ cell counts ≤200 cell/mm3. ART significantly reduces OPC. C. albicans is the most frequently isolated species colonization, non candida species are also emerging.