Virulence of oral Candida isolated from HIV-positive women with oral candidiasis and asymptomatic carriers.

Objective: This study compared the virulence of oral Candida species isolated from human immunodeficiency virus (HIV)-positive women with and without oral candidiasis.

Study Design: Candida species were isolated from 197 women, and their virulence attributes were measured.

Results: Of the 197 women, 117 (59.4%) carried Candida. Of these, 15 (12.8%) had symptoms of oral candidiasis. Among highly active antiretroviral therapy (HAART)-naive patients, 33% were diagnosed with oral candidiasis, whereas 5.9% were asymptomatic carriers (P < .01). C. albicans was the predominant species, with higher virulence attributes than non-albicans Candida. Women diagnosed with oral candidiasis had higher levels of Candida (P = .02) than asymptomatic carriers. There was no difference in the CD4 counts and the virulence attributes of Candida from both the groups.

Conclusions: This study indicates that oral candidiasis is mainly caused by high counts of C. albicans and suggests the importance of therapies targeting Candida counts in the oral cavity even in patients on HAART to reduce the development of infections.