Factors associated with the isolation of Candida Spp. from the oral microbiota of people living with HIV

Abstract

This study aimed to analyze the association between the isolation of Candida species in the oral cavity and the clinical and virulence factors of people living with Human immunodeficiency virus (HIV). This cross-sectional study, comprising 106 people living with HIV who were evaluated in an HIV-AIDS outpatient clinic in Fortaleza, Northeast of Brazil, data collection were conducted during August and November 2018. A saliva sample was also collected to isolate Candida. The virulence factors of extracellular and hemolytic phospholipase activities in isolated Candida strains were analyzed. The prevalence of oral Candida was 40.6%, and the presence of oral Candida was associated with smoking habits (p = .005), daily smoking (p = .026), low weight (p = .030), history of hospitalization (p = .014), TCD4 lymphocyte count < 200 cells/mm3 (p = .018), and detectable viral load (p = .005). The multivariate analysis revealed that the variables smoking habits (p = .008), viral load (p = .011), and body mass index (p = .011) were associated with the presence of oral Candida. Strong hemolytic and phospholipase activities were, respectively, identified in 74.4% and 72% of the isolated strains, mainly Candida albicans. As a main conclusion, the isolation of Candida from the oral cavity in people living with HIV/AIDS, has a strong association with the use of tobacco, even under anappropriate treatment.