Premium
Oral mycoses and other opportunistic infections in HIV : therapy and emerging problems – a workshop report
Author(s) -
Vidya KM,
Rao UK,
Nittayananta W,
Liu H,
Owotade FJ
Publication year - 2016
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/odi.12437
Subject(s) - fluconazole , immunosuppression , histoplasmosis , immunology , candida albicans , antiretroviral therapy , medicine , antifungal , opportunistic infection , candida auris , virulence , human immunodeficiency virus (hiv) , intensive care medicine , biology , microbiology and biotechnology , dermatology , viral disease , viral load , biochemistry , gene
Oral mycoses and other opportunistic infections are recognized features of HIV infection even after four decades of the epidemic. The therapeutic options, challenges of therapy, and evolving patterns of opportunistic infections were evaluated by the workshop. It was observed that high Candida counts and infection are still more prevalent in HIV ‐positive individuals even in the era of antiretroviral therapy. Furthermore, one or more non‐ Candida albicans are present in some HIV ‐positive individuals. While Candida species are more virulent in HIV infection, similar virulence may be present in other states of immunosuppression. Consequently, the interplay between host factors and virulence ultimately determines the clinical outcomes. Adverse clinical outcomes such as candidemia and other deep fungal infections are on the increase in HIV infection. Disseminated histoplasmosis and penicilliosis have been reported, especially with low CD 4 counts. Even with advances in antifungal therapy, mortality and morbidity from deep fungal infections have not changed significantly. In addition, long‐term exposure to common antifungal drugs such as fluconazole has led to the development of antifungal resistance in 6% to 36%. Development of new antifungal therapeutic agents and the use of alternative therapies may offer breakthrough. In addition, effective strategies to enhance the host immune status are being explored.