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Widaty S, Oktarina C, Suling PL, Niode NJ, Miranda E, Andriani A, Amin S, Yenny SW, Bramono K. Mucocutaneous mycoses in people living with human immunodeficiency virus in Indonesia. Mycoses 2021; 65:323-330. [PMID: 34902221 DOI: 10.1111/myc.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND To date, integrated care for people living with human immunodeficiency virus (PLHIV) has improved. However, although the management of mucocutaneous mycosis cases has improved, disease progression might be different in immunocompromised patients, which leads to variable clinical manifestations. OBJECTIVES To describe the characteristics of mucocutaneous mycosis cases in the PLHIV population and its associated factors in Indonesia. METHODS This retrospective study was conducted from January 2014 to December 2018 in four academic hospitals. Data were acquired from medical records with the inclusion of mucocutaneous mycosis patients with concurrent HIV infection. Analysis with the chi-squared test was performed using Statistical Package for the Social Sciences (SPSS) version 20.0. RESULTS A total of 1,796 cases of mucocutaneous mycoses were identified in 1782 PLHIV. The most common types of infection were candidiasis (63%), followed by dermatophytosis (35.1%), and malasseziosis (1.9%), which were significantly higher in PLHIV with CD4 level <200 cells/mm3 . The proportions of male gender (78.6% vs. 56.3%, p < .001), high level of education (48.0% vs. 64.1%, p < .001), office workers (73.8% vs. 64.1%, p < .001), combination of topical and systemic antifungal agents (59.1% vs. 48.5%, p = .006) and not receiving antiretroviral therapy (63.2% vs. 7.8%, p < .001) were significantly higher in PLHIV with a CD4 level <200 cells/mm3 . CONCLUSION In Indonesia, the most common fungal infection in PLHIV is candidiasis. This study also addressed the important matters regarding mucocutaneous mycoses in PLHIV. Education is an important measure to prevent the incidence of cutaneous mycoses in PLHIV, especially in high-risk groups.
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Affiliation(s)
- Sandra Widaty
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo National Central General Hospital, Central Jakarta, Jakarta, Indonesia.,Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia
| | - Caroline Oktarina
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo National Central General Hospital, Central Jakarta, Jakarta, Indonesia.,Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia
| | - Pieter Levinus Suling
- Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia.,Department of Dermatology and Venereology, Faculty of Medicine, Universitas Samratulangi - Prof. Dr. Kandou General Hospital, R. W. Monginsidi (Malalayang), Manado, Indonesia
| | - Nurdjannah Jane Niode
- Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia.,Department of Dermatology and Venereology, Faculty of Medicine, Universitas Samratulangi - Prof. Dr. Kandou General Hospital, R. W. Monginsidi (Malalayang), Manado, Indonesia
| | - Eliza Miranda
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo National Central General Hospital, Central Jakarta, Jakarta, Indonesia.,Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia
| | - Anni Andriani
- Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia.,Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University - dr. Wahidin Sudirohuosodo General Hospital, Makassar, Indonesia
| | - Safruddin Amin
- Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia.,Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University - dr. Wahidin Sudirohuosodo General Hospital, Makassar, Indonesia
| | - Satya Widya Yenny
- Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia.,Department of Dermatology and Venereology, Faculty of Medicine, Andalas University - M. Djamil General Hospital, Perintis Kemerdekaan, Padang, Indonesia
| | - Kusmarinah Bramono
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo National Central General Hospital, Central Jakarta, Jakarta, Indonesia.,Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia
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Navabi N, Ayatollahi-Mousavi SA, Anvari N. A Comparison of the Prevalence Rate of Oral Candida Colonization between Opium Users and Cigarette Smokers in Kerman, Iran. ADDICTION & HEALTH 2021; 13:106-113. [PMID: 34703531 PMCID: PMC8519615 DOI: 10.22122/ahj.v13i2.301] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/13/2021] [Indexed: 11/09/2022]
Abstract
Background Candidiasis is the most common opportunistic oral infection and smoking is considered as one of its well-known risk factors. However, it remains unknown whether opium users are susceptible to increased oral candida colonization. The aim of the present study is to compare the prevalence rate of oral candida colonization between opium users and cigarette smokers in Kerman, Iran. Methods This case-control study included 75 healthy male respondents divided into three groups (25 in each group): cigarette smokers, cigarette and opium users, and non-smokers as control group. The samples were obtained from oral mucosa by scraping the mucosa with a sterile cotton swab then inoculated into Sabouraud Dextrose Agar (SDA) and CHROMagar plates and also examined with the light microscope. Findings Candida was identified in 38.70% of respondents. The most frequently isolated species was Candida albicans (90.66%). The highest prevalence of candida carriage was found in cigarette smokers (52.00%). The difference of candida carriage between the two groups of cigarette smokers and cigarette plus opium users and the control group was statistically significant (P = 0.007 and P = 0.015, respectively). Conclusion In the present study, it was revealed that the prevalence of oral candida carriage was significantly higher among cigarette and opium users in comparison to the non-users.
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Affiliation(s)
- Nader Navabi
- Department of Diagnosis and Oral Medicine, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
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Indrastiti RK, Wardhany II, Soegyanto AI. Oral manifestations of HIV: Can they be an indicator of disease severity? (A systematic review). Oral Dis 2020; 26 Suppl 1:133-136. [PMID: 32862546 DOI: 10.1111/odi.13394] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To review the existing research literature on the paradigm that the oral lesions could be an indicator of the disease severity with the objective of documenting the current status of research, highlighting its major findings. MATERIAL AND METHODS Publications were identified through a careful search, of which a majority focused on oral lesions as an indicator for HIV progression. A PubMed journal search of 10 years OF period publication (2009-2019) for "oral lesion, oral manifestation, indicator, HIV and HIV-associated" was performed and analysed. Various research methods were included within the study criteria including clinical study, clinical trial, comparative study and randomised control trial. RESULTS A total 33 studies were obtained and analysed, including cohort study, cross-sectional study, case-control study, clinical trial, retrospective observational analysis study, prospective observational study and randomised control trial. The most common oral lesions found in the studies were Kaposi sarcoma (KS), followed by oral candidiasis, periodontitis, necrotising ulcerative gingivitis (NUG), necrotising ulcerative periodontitis (NUP) and oral hairy leucoplakia (OHL). The early diagnosis and accurate treatment plan were very important to indicate the disease severity related to HIV infection. CONCLUSION Oral lesions reported in 39% articles and could be an indicator of HIV disease severity due to its effects on decreased cluster-differentiated (CD4+) T-cell count and increased viral load.
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Affiliation(s)
- Ratna Kumala Indrastiti
- Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Indriasti I Wardhany
- Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Anandina I Soegyanto
- Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
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Castillejos-García I, Ramírez-Amador V, Gómez-Mejía E, Badial-Hernández F, Anaya-Saavedra G. Clinical manifestations and risk factors for oral immune reconstitution inflammatory syndrome in Mexico. Oral Dis 2020; 26 Suppl 1:153-157. [PMID: 32862543 DOI: 10.1111/odi.13402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The immune reconstitution inflammatory syndrome (IRIS) is a rare acute complication presenting in people living with HIV (PLWH) within the first 6 months of starting combined antiretroviral therapy (cART). While there is relevant information about its pathogenesis and clinical spectrum, IRIS-oral lesions (IRIS-OLs) have been scarcely described. Thus, to establish the incidence and clinical characteristics of IRIS-OLs, data from a cohort of 158 HIV individuals starting cART, followed for 6 months, were obtained retrospectively. IRIS-OLs developed in 11.4% of the individuals, in a median time of 87.5 days, with oral candidiasis being the most frequent manifestation detected in eight individuals (5.1%). The study emphasizes the importance of the correct diagnosis and management of these lesions.
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Affiliation(s)
- Itzel Castillejos-García
- Oral Pathology and Medicine Master, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - Velia Ramírez-Amador
- Oral Pathology and Medicine Master, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - Eduardo Gómez-Mejía
- Oral Pathology and Medicine Master, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | | | - Gabriela Anaya-Saavedra
- Oral Pathology and Medicine Master, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
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Ramírez-Amador V, Patton LL, Naglik JR, Nittayananta W. Innovations for prevention and care of oral candidiasis in HIV-infected individuals: Are they available?-A workshop report. Oral Dis 2020; 26 Suppl 1:91-102. [PMID: 32862535 DOI: 10.1111/odi.13391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Oral candidiasis (OC) is the most prevalent HIV-related oral lesion in patients on combined anti-retroviral therapy (cART) or without cART. Management is challenged in some patients by development of resistance to azole drugs, such as fluconazole. Recent scientific knowledge about OC pathogenesis, the role of OC in the immune reconstitution inflammatory syndrome (IRIS), the relationship of OC with the microbiome, and novelties in OC treatment was discussed in an international workshop format. Literature searches were conducted to address five questions: (a) Considering the pathogenesis of Candida spp. infection, are there any potential therapeutic targets that could be considered, mainly in HIV-infected individuals resistant to fluconazole? (b) Is oral candidiasis part of IRIS in HIV patients who receive cART? (c) Can management of the oral microbiome reduce occurrence of OC in patients with HIV infection? (d) What are the recent advances (since 2015) regarding plant-based and alternative medicines in management of OC? and (e) Is there a role for photodynamic therapy in management of OC in HIV-infected patients? A number of the key areas where further research is necessary were identified to allow a deeper insight into this oral condition that could help to understand its nature and recommend alternatives for care.
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Affiliation(s)
- Velia Ramírez-Amador
- Department of Health Care, Master´s Course in Oral Pathology and Oral Medicine, Universidad Autónoma Metropolitana-Xochimilco, México City, Mexico
| | - Lauren L Patton
- Division of Craniofacial and Surgical Care, Adams School of Dentistry University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julian R Naglik
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Gajdošová M, Vetchý D, Muselík J, Gajdziok J, Juřica J, Vetchá M, Hauptman K, Jekl V. Bilayer mucoadhesive buccal films with prolonged release of ciclopirox olamine for the treatment of oral candidiasis: In vitro development, ex vivo permeation testing, pharmacokinetic and efficacy study in rabbits. Int J Pharm 2020; 592:120086. [PMID: 33188896 DOI: 10.1016/j.ijpharm.2020.120086] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/04/2020] [Accepted: 11/08/2020] [Indexed: 10/23/2022]
Abstract
The incidence of fungal infections has increased in recent decades not only in patients with predisposing and risk factors, but it has also spread up due to the widespread use of broad-spectrum antibiotics, immunosuppressants and corticosteroids. A limited number of drugs are currently used to treat oral candidiasis (OC). There is an emerging need to look for new antifungals, to rework or to explore the already known molecules. Ciclopirox olamine (CPX), a broad-spectrum antifungal agent, is currently used for topical dermatologic treatment. In this study, bilayer mucoadhesive buccal films (MBFs) containing poly(ethylene oxide) (PEO) and Eudragit® NM 30D (EU) with the prolonged release of ciclopirox olamine, were developed for the treatment of oral candidiasis. During ex vivo testing it was found that CPX does not pass through the porcine buccal tissue but it accumulates in it, which may be beneficial for the treatment of candidiasis in the oral cavity. In a pharmacokinetic study, the drug release from mucoadhesive films was prolonged with the maximum plasma concentration at 3.4 (1.4; 5.5) h. All rabbits with stomatitis showed progressive healing after the treatment with CPX bilayer mucoadhesive buccal films without organ pathologies.
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Affiliation(s)
- Markéta Gajdošová
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Masaryk University, 62500 Brno, Czech Republic
| | - David Vetchý
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Masaryk University, 62500 Brno, Czech Republic.
| | - Jan Muselík
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Masaryk University, 62500 Brno, Czech Republic
| | - Jan Gajdziok
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Masaryk University, 62500 Brno, Czech Republic
| | - Jan Juřica
- Department of Pharmacology, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | | | - Karel Hauptman
- Veterinary Clinic Jekl & Hauptman, 61200 Brno, Czech Republic
| | - Vladimír Jekl
- Veterinary Clinic Jekl & Hauptman, 61200 Brno, Czech Republic; The Avian and Exotic Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, 61242 Brno, Czech Republic
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Lamichhane K, Adhikari N, Bastola A, Devkota L, Bhandari P, Dhungel B, Thapa Shrestha U, Adhikari B, Banjara MR, Rijal KR, Ghimire P. Biofilm-Producing Candida Species Causing Oropharyngeal Candidiasis in HIV Patients Attending Sukraraj Tropical and Infectious Diseases Hospital in Kathmandu, Nepal. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:211-220. [PMID: 32606995 PMCID: PMC7304782 DOI: 10.2147/hiv.s255698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/27/2020] [Indexed: 12/16/2022]
Abstract
Introduction Oropharyngeal candidiasis are the commonest fungal infections among HIV-positive patients. The main objective of this study was to explore biofilm-producing Candida species causing oropharyngeal infections among HIV patients attending Sukraraj Tropical and Infectious Diseases Hospital (STIDH) in Kathmandu, Nepal. Methods Oropharyngeal swabs were collected from the HIV-positive patients between July and December 2019. A total of 174 oropharyngeal swabs were cultured on Sabouraud Dextrose Agar (SDA). All samples were inoculated on SDA slants supplemented with chloramphenicol and underwent incubation at 37°C for 24-48 hours. Any visible growth reported was processed for the identification of the species. Candida species were differentiated based on the growth and colour of the isolates on CHROM agar candida. Biofilm production in Candida species was determined by the microtiter plate method (MPM). Antifungal susceptibility testing was performed using the disc diffusion method. Results Among 174 oropharyngeal samples, 23.6% (n=41/174) of them had oropharyngeal infections and 36.6% of the oropharyngeal infections (15/41) had CD4 T-lymphocytes count below 200 cells/mm3 who were also active tobacco users (p<0.05). Among Candidial growth, 61% (25/41) were Candida albicans and 39% (16/41) were non-albicans. Of 41 Candida spp., 65% (27/41) were biofilm producers. An equal proportion of Candida albicans (4 isolates) and non-albicans (4 isolates) were strong biofilm producers. C. albicans isolates were sensitive towards clotrimazole (96%; 24/25) and fluconazole (92%; 23/25), whereas sensitivity towards ketoconazole was only 48% (12/25). Non-albicans Candida was highly sensitive to amphotericin-B (62.5%; 10/16) followed by clotrimazole (56.2%; 9/16). The biofilm-producing Candida isolates showed the highest resistivity (51.9%; 14/27) to ketoconazole and lowest (22.2%; 6/27) to clotrimazole. Conclusion Oropharyngeal candidiasis is a common opportunistic infection among HIV-infected individuals. The majority of cases of oropharyngeal candidiasis are caused by biofilm producers Candida albicans and non-albicans Candida. Biofilm producers Candida were more resistant towards commonly used antifungal drugs.
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Affiliation(s)
- Keshav Lamichhane
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Nabaraj Adhikari
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Anup Bastola
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
| | - Lina Devkota
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
| | | | - Binod Dhungel
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | | | - Bipin Adhikari
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Komal Raj Rijal
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Prakash Ghimire
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
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Suryana K, Suharsono H, Antara IGPJ. Factors Associated with Oral Candidiasis in People Living with HIV/AIDS: A Case Control Study. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:33-39. [PMID: 32021484 PMCID: PMC6969700 DOI: 10.2147/hiv.s236304] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/20/2019] [Indexed: 12/11/2022]
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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Affiliation(s)
- Ketut Suryana
- Department of Internal Medicine, Wangaya Hospital of Denpasar, Bali, Indonesia
| | - Hamong Suharsono
- Department of Biochemistry, Veterinary Faculty of Udayana, University of Denpasar, Bali, Indonesia
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Epidemiology, risk factors and outcomes of Candida albicans vs. non- albicans candidaemia in adult patients in Northeast China. Epidemiol Infect 2019; 147:e277. [PMID: 31552814 PMCID: PMC6805752 DOI: 10.1017/s0950268819001638] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
This study aimed to evaluate the clinical characteristics, risk factors and outcomes of adult patients with candidaemia caused by C. albicans vs. non-albicans Candida spp. (NAC). All adult hospitalised cases of candidaemia (2012-2017) at a tertiary hospital in Shenyang were included in the retrospective study, and a total of 180 episodes were analysed. C. parapsilosis was the most frequently isolated species (38.3%), followed by C. albicans (35.6%), C. glabrata (13.9%), C. tropicalis (10%) and others (2.2%). As initial antifungal therapy, 75.0%, 3.9%, 5.6% and 2.2% of patients received fluconazole, caspofungin, micafungin and voriconazole, respectively. Multivariate analyses revealed that total parenteral nutrition was associated with an increased risk of NAC bloodstream infections (BSI) (OR 2.535, 95% CI (1.066-6.026)) vs. C. albicans BSI. Additionally, the presence of a urinary catheter was associated with an increased risk of C. albicans BSI (OR 2.295 (1.129-4.666)) vs. NAC BSI. Moreover, ICU stay (OR 4.013 (1.476-10.906)), renal failure (OR 3.24 (1.084-9.683)), thrombocytopaenia (OR 7.171 (2.152-23.892)) and C. albicans (OR 3.629 (1.352-9.743)) were independent risk factors for candidaemia-related 30-day mortality, while recent cancer surgery was associated with reduced mortality risk (OR 26.479 (2.550-274.918)). All these factors may provide useful information to select initial empirical antifungal agents.
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Muralidharan S, Acharya AK, Margabandhu S, Kalekhan S, Ahsan S, Kulkarni D. Prevalence of Periodontitis and Soft Tissue Lesions among Human Immunodeficiency Virus-positive Patients on Antiretroviral Therapy in Raichur Taluk, Karnataka, India. J Contemp Dent Pract 2018; 19:42-46. [PMID: 29358533 DOI: 10.5005/jp-journals-10024-2209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION In countries where human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is widespread and highly active antiretroviral therapy (HAART) medications are too expensive, or patients are failing HAART, oral disease management and risk remain an important issue. AIM The aim of the study was to evaluate the prevalence of oral mucosal lesions and periodontitis among the HIV-positive adult patients and assess the association of these lesions with age, sex, duration of HIV, time on ART, dietary habits, and oral hygiene habits. MATERIALS AND METHODS Sample size was 170. Demographic data of the patients along with community periodontal index (CPI) and loss of attachment (LA) were recorded. Oral soft tissue lesions, such as ulcerations, sores, erosions, and fissures were also recorded. The study was carried out in Raichur Taluk, Karnataka, India. Convenience sampling design was followed. Statistical Package for the Social Sciences (SPSS) version 20.0 (Chicago, USA) was used for data analysis. Chi-square test was carried out; p < 0.05 was considered to be statistically significant. RESULTS There was no association between the oral mucosal conditions and the age and the adverse habits, such as tobacco and alcohol, CD4 count, and the time duration of HIV and ART among these patients. A higher percentage of people with 4 to 5 mm of pockets was seen with those who cleaned their teeth with a finger, which was statistically significant. CLINICAL SIGNIFICANCE The present study highlights the poor condition of the oral health of these patients and their unmet dental needs.
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Affiliation(s)
- Shrikanth Muralidharan
- Department of Public Health Dentistry, M. A. Rangoonwala College of Dental Sciences & Research Centre, Pune, Maharashtra, India, India, Phone: +918308008831, e-mail:
| | - Arun Kumar Acharya
- Department of Public Health Dentistry, Navodaya Dental College & Hospital, Raichur, Karnataka, India
| | - Shanthi Margabandhu
- Department of Public Health Dentistry, Mathrushri Ramabai Ambedkar Dental College and Hospital, Bengaluru, Karnataka India
| | - Sufiyan Kalekhan
- Department of Prosthodontics, KVG Dental College and Hospital, Sullia, Karnataka, India
| | | | - Dinraj Kulkarni
- Department of Oral pathology, M. A. Rangoonwala College of Dental Sciences & Research Centre, Pune, Maharashtra India
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Kim YJ, Woo JH, Kim MJ, Park DW, Song JY, Kim SW, Choi JY, Kim JM, Han SH, Lee JS, Choi BY, Lee JS, Kim SS, Kee MK, Kang MW, Kim SI. Opportunistic diseases among HIV-infected patients: a multicenter-nationwide Korean HIV/AIDS cohort study, 2006 to 2013. Korean J Intern Med 2016; 31:953-60. [PMID: 27117317 PMCID: PMC5016273 DOI: 10.3904/kjim.2014.322] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 01/06/2015] [Accepted: 04/27/2015] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS The frequencies of opportunistic diseases (ODs) vary across countries based on genetic, environmental, and social differences. The Korean HIV/AIDS cohort study was initiated in 2006 to promote research on human immunodeficiency virus (HIV) infection in Korea, and to provide a logistical network to support multicenter projects on epidemiological, clinical, and laboratory aspects of HIV infection. This study evaluated the prevalence of ODs among HIV-infected patients in the era of highly active antiretroviral therapy, and the risk factors associated with ODs. METHODS The study enrolled 1,086 HIV-infected patients from 19 hospitals. This study examined the baseline data of the HIV/AIDS Korean cohort study at the time of enrollment from December 2006 to July 2013. RESULTS Candidiasis was the most prevalent opportunistic infection (n = 176, 16.2%), followed by Mycobacterium tuberculosis infection (n = 120, 10.9%), Pneumocystis jirovecii pneumonia (n = 121, 11.0%), cytomegalovirus infection (n = 52, 4.7%), and herpes zoster (n = 44, 4.0%). The prevalence rates of Kaposi's sarcoma (n = 8, 0.7%) and toxoplasmosis (n = 4, 0.4%) were very low compared with other countries. The risk factors for ODs were a low CD4 T cell count at the time of HIV diagnosis (odds ratio [OR], 1.01; p < 0.01), current smoking (OR, 2.27; p = 0.01), current alcohol use (OR, 2.57; p = 0.04), and a history of tuberculosis (OR, 5.23; p < 0.01). CONCLUSIONS Using recent Korean nationwide data, this study demonstrated that an important predictor of ODs was a low CD4 T cell count at the time of HIV diagnosis. Tuberculosis remains one of the most important ODs in HIV-infected patients in Korea.
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Affiliation(s)
- Youn Jeong Kim
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jun Hee Woo
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ja Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dae Won Park
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joon-Young Song
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Shin Woo Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jun Yong Choi
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - June Myung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-Soo Lee
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Bo Youl Choi
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Joo Shil Lee
- Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Sung-Soon Kim
- Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Mee-Kyung Kee
- Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Moon Won Kang
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Sang Il Kim
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
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Current strategies for prevention of oral manifestations of human immunodeficiency virus. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 121:29-38. [PMID: 26679357 DOI: 10.1016/j.oooo.2015.09.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/08/2015] [Accepted: 09/02/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Strategies to prevent new-onset and recurrent oral manifestations of human immunodeficiency virus (HIV), including fungal, viral, neoplastic, and idiopathic mucosal diseases and destructive periodontal conditions, are poorly understood. STUDY DESIGN A structured review of the English language literature in PubMed through March 2015 was conducted to identify current prevention strategies for initial and recurrent oral manifestations of HIV. RESULTS Pharmacologic approaches, including combination antiretroviral therapy or other targeted therapies for prevention of oropharyngeal candidiasis, orolabial herpes, oral hairy leukoplakia, oral Kaposi sarcoma, linear gingival erythema and necrotizing ulcerative periodontitis were found. Nonpharmacologic approaches for prevention of oropharyngeal candidiasis, orolabial herpes, oral hairy leukoplakia, and necrotizing ulcerative periodontitis are presented. CONCLUSIONS Current strategies for the prevention of oral manifestations of HIV include pharmacologic and nonpharmacologic therapies. Immune reconstitution inflammatory syndrome, future vaccine therapy for pathogens causing oral mucosal disease, and the possible role of oral inflammatory disease prevention in controlling HIV disease progression are discussed.
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Keten HS, Keten D, Ucer H, Yildirim F, Hakkoymaz H, Isik O. Prevalence of oral Candida carriage and Candida species among cigarette and maras powder users. Int J Clin Exp Med 2015; 8:9847-9854. [PMID: 26309667 PMCID: PMC4538155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/28/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The aim of this study was to determine the prevalence of Candida carriage and Candida species among cigarette and Maras powder (MP) users. MATERIAL AND METHODS This study was conducted on 180 volunteering men in 20 cafehouses in the city of Kahramanmaras, Turkey. The sociodemographic characteristics of the participants and the behaviors of MP and cigarette usage were noted down. Culture specimens were obtained from bilateral buccal mucosa and dorsum of the tongue with a sterile cotton-tipped swap. RESULTS The specimens were inoculated into Sabouraud Dextrose Agar. The mean age of the participants was 40.49 ± 12.89 years (min = 18, max = 87). Fifty-eight percent of the cigarette users, 56.7% of the MP users, and 36.7% of the control group were Candida carriers. The difference of Candida carriage between cigarette and MP users and the control group was statistically significant (P = 0.018 and P = 0.029 respectively). The prevalence of Candida carriage was similar between cigarette and MP users (P = 0.854). The most frequently isolated species was Candida albicans at a rate of 30% in the cigarette users' group, 28.3% in the MP users' group and at a rate of 18.3% in the controls. The prevalence of Candida tropicalis carriage was found to be at a rate of 20% in cigarette and 21.7% in the MP users' group compared to 11.7% in the nonusers. CONCLUSIONS In the present study we found that the prevalence of oral Candida carriage was significantly higher among cigarette and MP users.
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Affiliation(s)
- Hamit Sirri Keten
- Department of Family Medicine, Onikisubat Community Health CenterKahramanmaras, Turkey
| | - Derya Keten
- Department of Clinical Microbiology and Infectious Diseases, Necip Fazil City Hospital KahramanmarasTurkey
| | - Huseyin Ucer
- Department of Family Medicine, Medical Faculty, Kahramanmaras Sutcu Imam UniversityKahramanmaras, Turkey
| | - Fatis Yildirim
- Department of Family Medicine, Medical Faculty, Kahramanmaras Sutcu Imam UniversityKahramanmaras, Turkey
| | - Hakan Hakkoymaz
- Department of Emergency Medicine, Medical Faculty, Kahramanmaras Sutcu Imam UniversityKahramanmaras, Turkey
| | - Oguz Isik
- Department of Family Medicine, Medical Faculty, Kahramanmaras Sutcu Imam UniversityKahramanmaras, Turkey
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Javed F, Samaranayake LP, Romanos GE. Treatment of oral fungal infections using antimicrobial photodynamic therapy: a systematic review of currently available evidence. Photochem Photobiol Sci 2015; 13:726-34. [PMID: 24686309 DOI: 10.1039/c3pp50426c] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The aim was to review the efficacy of antimicrobial photodynamic therapy (PDT) in the treatment of oral fungal infections. To address the focused question "Should PDT be considered a possible treatment regimen for oral fungal infections?" PubMed/Medline and Google-Scholar databases were searched from 1997 up to March 2014 using various combinations of the following key words: "Candida albicans"; "Candidiasis"; "Candidosis"; "denture stomatitis"; "oral" and "photodynamic therapy". Original studies, experimental studies and articles published solely in English language were sought. Letters to the editor, historic reviews and unpublished data were excluded. Pattern of the present literature review was customized to mainly summarize the pertinent information. Fifteen studies (3 clinical and 12 experimental) were included. All studies reported antimicrobial PDT to be an effective antifungal treatment strategy. One study reported PDT and azole therapy to be equally effective in the treatment of oral fungal infections. Methylene blue, toluidine blue and porphyrin derivative were the most commonly used photosensitizers. The laser wavelengths and power output ranged between ∼455 nm-660 nm and 30 mW-400 mW. The energy fluence ranged between 26-245 J cm(-2) and the duration or irradiation ranged between 10 seconds and 26 minutes. Clinical effectiveness of antimicrobial PDT as a potent therapeutic strategy for oral fungal infections requires further investigations.
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Affiliation(s)
- Fawad Javed
- Research Associate, Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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Ompad DC, Kingdon M, Kupprat S, Halkitis SN, Storholm ED, Halkitis PN. Smoking and HIV-related health issues among older HIV-positive gay, bisexual, and other men who have sex with men. Behav Med 2014; 40:99-107. [PMID: 25090362 PMCID: PMC4397913 DOI: 10.1080/08964289.2014.889067] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The prevalence of cigarette smoking and the relations between smoking and HIV clinical markers, HIV medication adherence, and opportunistic infections (OIs) were examined in a sample of 199 HIV-positive, gay, bisexual, and other men who have sex with men (MSM) aged 50 and older. Overall, 35.7% were current smokers, 35.7% were former smokers, and 28.6% were never smokers. In the final multivariable polytomous logistic regression model controlling for age, income, and illicit drug use, current smokers were less likely to report an undetectable viral load as compared to never and former smokers. Relative to never smokers, former smokers were more likely to report respiratory OIs, and current smokers were more likely to report gastrointestinal OIs. This study demonstrates high prevalence of cigarette smoking among aging, HIV-positive MSM and provides additional evidence for a relationship between smoking and poorer HIV clinical markers. Targeted and tailored smoking cessation programs within the context of HIV care services are warranted.
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Affiliation(s)
- Danielle C. Ompad
- Center for Health, Identity, Behavior, & Prevention Studies (CHIBPS), Steinhardt School of Culture, Education and Human Development, New York University, New York, NY,Center for Drug Use and HIV Research, New York University College of Nursing, New York, NY
| | - Molly Kingdon
- Center for Health, Identity, Behavior, & Prevention Studies (CHIBPS), Steinhardt School of Culture, Education and Human Development, New York University, New York, NY
| | - Sandra Kupprat
- Center for Health, Identity, Behavior, & Prevention Studies (CHIBPS), Steinhardt School of Culture, Education and Human Development, New York University, New York, NY
| | - Sophia N. Halkitis
- Center for Health, Identity, Behavior, & Prevention Studies (CHIBPS), Steinhardt School of Culture, Education and Human Development, New York University, New York, NY
| | - Erik David Storholm
- Center for Health, Identity, Behavior, & Prevention Studies (CHIBPS), Steinhardt School of Culture, Education and Human Development, New York University, New York, NY
| | - Perry N. Halkitis
- Center for Health, Identity, Behavior, & Prevention Studies (CHIBPS), Steinhardt School of Culture, Education and Human Development, New York University, New York, NY
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Abstract
Human immunodeficiency virus (HIV)-associated oral disease among people living with HIV infection includes oral candidiasis, oral hairy leukoplakia, Kaposi sarcoma, oral warts, herpes simplex virus ulcers, major aphthous ulcers or ulcers not otherwise specified, HIV salivary gland disease, and atypical gingival and periodontal diseases. Diagnosis of some oral lesions is based on clinical appearance and behavior, whereas others require biopsy, culture, or imaging for definitive diagnosis. Management strategies including pharmacologic and nonpharmacologic approaches are discussed in this article. Dentists also need to be cognizant of the potential oral side effects of HIV antiretroviral medications.
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MESH Headings
- AIDS-Related Opportunistic Infections/diagnosis
- AIDS-Related Opportunistic Infections/therapy
- Antiretroviral Therapy, Highly Active/adverse effects
- Candidiasis, Oral/diagnosis
- Candidiasis, Oral/etiology
- Candidiasis, Oral/therapy
- HIV Infections/complications
- Humans
- Leukoplakia, Hairy/diagnosis
- Leukoplakia, Hairy/etiology
- Leukoplakia, Hairy/therapy
- Mouth Mucosa/pathology
- Mouth Neoplasms/diagnosis
- Mouth Neoplasms/etiology
- Sarcoma, Kaposi/diagnosis
- Sarcoma, Kaposi/etiology
- Sarcoma, Kaposi/therapy
- Sialadenitis/diagnosis
- Sialadenitis/etiology
- Sialadenitis/therapy
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Affiliation(s)
- Lauren L Patton
- Department of Dental Ecology, School of Dentistry, University of North Carolina, Room 467A, Brauer Hall, Chapel Hill, NC 27599-7450, USA.
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