The effect of antiretroviral therapy on the prevalence of HIV-associated oral candidiasis in a Spanish cohort

Objective. To investigate the temporal changes in the prevalence of oral candidiasis in a cohort of Spanish human immunodeficiency virus (HIV)-infected individuals, before and after the introduction of highly active antiretroviral therapy (HAART). Study design. Retrospective analysis of a clinical database from "Carlos Haya" Hospital, Málaga, Spain, from 1995 to 2000. The prevalence of oral candidiasis was assessed in 807 HIV/AIDS patients and the temporal progression of its major variants evaluated using a linear regression model. Results. Overall oral candidiasis was prevalent in 30.0% to 48.3% of the cohort throughout and no significant variation in its incidence was noted during the study period. Prevalence of erythematous candidiasis increased from 24.5% (1995) to 45.0% (2000) and pseudomembranous candidiasis decreased from 22.4% (1995) to 5.2% (2000) (P<.05). Hyperplastic candidiasis was not detected in the cohort after the introduction of HAART therapy. Conclusions. Although oral candidiasis in HIV-infected Spanish individuals has not decreased significantly after the introduction of HAART, there appears to be a significant reduction in hyperplastic and pseudomembranous variants of the disease with a compensatory increase in erythematous candidiasis.link_to_subscribed_fulltex

Anticandida Agents from a Tanzanian Plant Albizia anthelmintica.

noCandidiasis is one of the most frequent opportunistic infections in individuals with severe immunosupression and further development of resistance against the available antifungal drugs has created an alarming situation. This requires intensive drug discovery to develop new, more effective, affordable and accessible antifungal agents possessing novel modes of action. Albizia anthelmintica, which is ethno medically used to treat vaginal candidiasis in the Morogoro and coastal regions of Tanzania, on activity guided fractionation and subsequent purification resulted in the isolation and characterization of an isomer of methyl cyclitol (1) and six echinocystic acid saponins (2–7). Saponins 6 and 7 are new and being reported for the first time from nature. Among all the isolated compounds, 3-O-[α-L-arabinopyranosyl (1[RIGHTWARDS ARROW]2)][α-L-arabinopyranosyl (1[RIGHTWARDS ARROW]6)]-2-acetamido-2-deoxy-β-D-glucopyranosyl echinocystic acid (4), 3-O-[α-L-arabinopyranosyl (1[RIGHTWARDS ARROW]2)] [α-L-arabinopyranosyl (1[RIGHTWARDS ARROW]6)]-2-amino-2-deoxy-β-D-glucopyranosyl echinocystic acid (6) and 3-O-[β-D-glucopyranosyl (1[RIGHTWARDS ARROW]3)] [α-L-arabinopyranosyl (1[RIGHTWARDS ARROW]2)] [α-L-arabinopyranosyl (1[RIGHTWARDS ARROW]6)]-2-amino-2-deoxy-β-D-glucopyranosyl echinocystic acid (7) and their combinations were active against the various strains of C. albicans with MICs ranging from 12.5 to 125 μg/ml

Longitudinal study on oral shedding of herpes simplex virus 1 and varicella-zoster virus in individuals infected with HIV

Primary herpes simplex virus 1 (HSV-1) and varicella-zoster virus (VZV) infection leads to a life-long latent infection of ganglia innervating the oral mucosa. HSV-1 and VZV reactivation is more common in immunocompromised individuals and may result in viral shedding in saliva. We determined the kinetics and quantity of oral HSV-1 and VZV shedding in HSV-1 and VZV seropositive individuals infected with HIV and to assess whether HSV-1 shedding involves reactivation of the same strain intra-individually. HSV-1 and VZV shedding was determined by real-time PCR of sequential daily oral swabs (n=715) collected for a median period of 31 days from 22 individuals infected with HIV. HSV-1 was genotyped by sequencing the viral thymidine kinase gene. Herpesvirus shedding was detected in 18 of 22 participants. Shedding of HSV-1 occurred frequently, on 14.3% of days, whereas solely VZV shedding was very rare. Two participants shed VZV. The median HSV-1 load was higher compared to VZV. HSV-1 DNA positive swabs clustered into 34 shedding episodes with a median duration of 2 days. The prevalence, duration and viral load of herpesvirus shedding did not correlate with CD4 counts and HIV load. The genotypes of the HSV-1 viruses shed were identical between and within shedding episodes of the same person, but were different between individuals. One-third of the individuals shed an HSV-1 strain potentially refractory to acyclovir therapy. Compared to HSV-1, oral VZV shedding is rare in individuals infected with HIV. Recurrent oral HSV-1 shedding is likely due to reactivation of the same latent HSV-1 strain