Candida colonisation in asymptomatic HIV patients attending a tertiary hospital in Benin City, Nigeria

Background: Candidiasis is the commonest opportunistic fungal infection in patients infected with human immunodeficiency virus (HIV). CD4 lymphocyte counts have been found to be a marker of HIV disease progression.Aim: This study focused on determining the spectrum of Candida isolates in urine, stool, and oral specimens among HIV patients in a tertiary hospital.Methods: A total of 300 subjects comprising of 200 HIV patients and 100 non-HIV subjects were used for this study. Three samples (urine, stool, and oral swab) were collected from each subject. Each specimen was processed using standard microbiological techniques and emergent Candida isolates were identified with CHROMagarTM Candida and sugar fermentation tests.Results: The overall prevalence of Candida colonisation among HIV patients was 52.5%. HAART-naive patients had a significantly higher prevalence (OR3.65; 95% CI2.036.56; pB0.0001) than their counterpart on highly active antiretroviral therapy (HAART) (OR1.99; 95% CI1.133.50; p0.0232). Female gender was a significant risk factor for acquiring Candida infection (OR3.40; 95% CI1.1410.13; p0.0289). The effect of age on prevalence of candidiasis was observed among HIV patients on HAART (p0.0161). A CD4count B200 cells/ml was a significant risk factor for acquiring candidal infection only among HAART-naive patients (OR4.37; 95% CI1.6011.95; p0.0042). The five species of Candida recovered from this study were C. albicans, C. krusei, C. parapsilosis, C. tropicalis, and C. glabrata. Conclusion: There is a significant relationship between antiretroviral therapy, CD4 counts, and the prevalence of candidiasis.Keywords: HAART; HAART-naive; Candida colonisation; CD4 counts; prevalenc

Candiduria among HIV- Infected Patients Attending a Tertiary Hospital in Benin City

Background: Candiduria is a common finding. However, in  immunocompromised patients like HIV-infected individuals, it has high risk of morbidity and mortality as it could be a pointer to systemic candidiasis. Unfortunately, there are no clear criteria for differentiating between colonization and infection or between upper or lower urinary tract infections.Objective: This study focused on determining the spectrum of Candida species implicated in candiduria among HIV-infected individuals and theirsusceptibility to fluconazole and voriconazole in a tertiary hospital.Methods: A total of 300 subjects comprising of 200 HIV patients and 100 non-HIV individuals were used for this study. Clean catch midstream were collected from each individual and processed using standard  microbiological techniques. Emergent Candida isolates were identified with CHROMagar Candida and sugar fermentation tests.Results: The overall prevalence of candiduria among HIV patients was 13.5%. HAART-naive patients had a significantly higher prevalence  (OR=4.165, 95%CI=1.602, 10.828; P=0.0038) than their counterpart on highly active antiretroviral therapy (HAART). Female gender was a  significant risk factor for acquiring candiduria. Age had no significant effect on the prevalence of candiduria in this study. A CD4+ count <200 cells/µl was a significant risk factor for acquiring candiduria only among  HAART-naive patients (OR=11.711; 95%CI=3.943, 34.780; P= 0.0001). The three species of Candida recovered from this study were C. albicans, C. krusei and C.parapsilosis. C. albicans (64.52%, 83.36%) and C. krusei (66.67%, 100.00%) were resistant to fluconazole and voriconazole  respectively.Conclusion: There is a significant relationship between  antiretroviral therapy, CD4+ counts, and the prevalence of candiduria among the study population.Keywords:HAART, HAART-naive, candiduria, CD4+ counts, Candida,  prevalence. Contexte: La candidurie est un problème commun de sante publique. Cependant, chez les patients immunodéprimés comme les individus infectés par le VIH, elle présente un risque élevé de morbidité puisqu’elle peut évoluer vers la candidose systémique. Malheureusement, il n'existe pas de critères clairs permettant de distinguer la colonisation et l'infection de même que les infections des voies urinaires supérieures et inférieures.Objectif: Cette étude a porté sur la détermination du spectre d'espèces de Candida impliqués dans la candidurie chez les personnes infectées par le VIH et leur sensibilité au fluconazole et voriconazole dans un hôpital tertiaire.Methodes : Un total de 300 sujets comprenant 200 patients atteints du VIH et 100 personnes non -VIH ont été utilisés dans cette étude. Les echantillons d’urine ont été collectées auprès de chaque personne par la methode de ‘‘Clean catch midstream’’et traitées en utilisant des techniques microbiologiques standard. Les isolats émergents de Candida ont été identifiés avec CHROMagar Candida et les tests de fermentation de sucre. Résultats : La prévalence globale du VIH chez les patients atteints de candidurie était de 13,5%. Les patients en naïfs de la multithérapie HAARTavaient une prévalence significativement plus élevée (OR = 4,165, IC à 95% =1,602, 10,828, p = 0,0038 ) par rapport a leurs homologues sous traitement antiretroviral hautement actif (HAART ) . Le sexe feminin etait un facteur de risque important d'acquisition de candidurie. L'age n'avait pas d'effet significat nif sur la prevalence de candidurie dans cette etude. Un compte de CD4 + < 200 cellules / µl ete un facteur de risque important pour l'acquisition de candidurie que chez les patients en multitherapie naifs (OR = 11,711 ; IC a 95% = 3, 943, 34, 780, p = 0,0001). Les trois especes de Candida recuperes de cette etude etaient C. albicans, C. krusei et C.parapsilosis. C. albicans(64,52%, 83,36 %) et C. krusei (66,67%, 100,00 %) etaient resistants respectivement au  fluconazole et voriconazole.Conclusion: Il existe une relation significative entre le traitement  antiretroviral, CD4 +, et la prevalence de candidurie parmi la population de l'etude..Mots-cles: multitherapie HAART , naifs , candidurie , CD4 + , Candida , prevalence