How do different antifungal agents compare for treating oropharyngeal candidiasis associated with HIV infection in adults?

2014 ◽  
Keyword(s):  
Hiv Infection ◽  
Antifungal Agents ◽  
Oropharyngeal Candidiasis

scholarly journals Comparative Efficacy of Antifungal Agents Used in the Treatment of Oropharyngeal Candidiasis among HIV-Infected Adults: A Systematic Review and Network Meta-Analysis

2021 ◽  
Vol 7 (8) ◽  
pp. 637
Author(s):  
Shamala Gopal Rajadurai ◽  
Mari Kannan Maharajan ◽  
Sajesh K. Veettil ◽  
Divya Gopinath
Keyword(s):  
Antifungal Agents ◽  
Meta Analysis ◽  
Oropharyngeal Candidiasis ◽  
Mycological Cure ◽  
Comparative Efficacy ◽  
Assessment Development ◽  
Randomized Controlled ◽  
Favorable Safety ◽  
Grade Approach

The objective of this study was to assess the comparative efficacy and safety of different antifungal agents used for the treatment of oropharyngeal candidiasis (OPC) in adult patients with HIV. A systematic search was performed on the four major databases (Medline, Embase, CENTRAL and Scopus) to identify randomized controlled trials (RCTs) that evaluated the efficacy of antifungal agents in HIV patients with OPC. A network meta-analysis was performed from the data extracted from the selected studies. The agents were ranked according using surface under the cumulative ranking (SUCRA). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to determine the quality of evidence. A total of 15 trials were included in the quantitative analysis involving the data from a total of 2883 participants. Fluconazole was ranked as the most effective antifungal agent to achieve clinical cure (SUCRA = 0.87) in OPC followed by posaconazole and itraconazole. Posaconazole was ranked the most efficacious agent in achieving mycological cure (SUCRA = 0.81), followed by fluconazole. While nystatin was ranked the safest, the effect estimates of none of the other systemic antifungal agents were significantly higher than fluconazole. Based on the available evidence, fluconazole can be considered as the most effective drug in the treatment of OPC among HIV-infected adults and has a favorable safety profile, followed by posaconazole.

Stridor in patients with HIV infection

1995 ◽  
Vol 109 (12) ◽  
pp. 1197-1199 ◽  
Author(s):  
R. B. S. Laing ◽  
P. J. C. Wardrop ◽  
P. D. Welsby ◽  
R. P. Brettle
Keyword(s):  
Hiv Infection ◽  
Broad Spectrum ◽  
Antifungal Agents ◽  
Opportunistic Infections ◽  
Upper Airways ◽  
Airway Intervention ◽  
Advanced Immunodeficiency ◽  
Laryngeal Tumours ◽  
Antibacterial And Antifungal

AbstractThe immunodeficiency which results from HIV infection is associated with a range of opportunistic infections and tumours which may present with the symptoms of upper airways disease. This paper presents three cases of stridor from different causes in patients with HIV infection, all of whom recovered following treatment. The management of this problem requires consideration of the likely aetiology which, in those with advanced immunodeficiency, includes bacterial and fungal laryngitis and epiglottitis as well as rapidly growing laryngeal tumours. Recommendations for the treatment of those with HIV infection who present with severe or rapidonset stridor should include a combination of aggressive airway intervention and broad-spectrum antibacterial and antifungal agents. Laryngeal biopsy for histology and culture is particularly important for those patients who fail to respond to the aforementioned treatment.

scholarly journals Oropharyngeal candidiasis in HIV/AIDS patients and HIVfree subjects in the Southeast of Iran

2019 ◽  
Author(s):  
Abbas Hosain Pour ◽  
Samira Salari ◽  
Pooya Ghasemi Nejad Almani
Keyword(s):  
Hiv Infection ◽  
Candida Species ◽  
Age Group ◽  
Oropharyngeal Candidiasis ◽  
Aids Patients ◽  
Immunodeficiency Virus ◽  
Initial Sign ◽  
Effective Drugs ◽  
Isolated Species ◽  
Hiv Aids

Background and Purpose: Candida species are the common opportunistic pathogens during the course of human immunodeficiency virus (HIV) infection. Oropharyngeal candidiasis (OPC) is generally known as the initial sign of HIV infection. The aim of this study was to compare demographic characteristics and frequency of Candida species between HIV/AIDS patients and HIV-free subjects in Kerman, southeast of Iran. Materials and Methods: This study was conducted on 143 samples collected from the oral cavity of 81 HIV/AIDS patients and 35 HIV-free subjects. The samples were cultured on Sabouraud dextrose agar and CHROMagar. The identification of Candida species was accomplished using the color of colony and polymerase chain reactionrestriction fragment length polymorphism. Results: According to the results, C. albicans (n=25, 69.14%) was the most prevalent species isolated from the HIV/AIDS patients, followed by C. glabrata (n=19, 23.46%). Other isolated species included C. parapsilosis (n=4, 4.94 %), C. krusei (n=1, 1.24%), and C. kefyr (n=1, 1.24%). Out of the 35 Candida species recovered from the oral samples of HIV-free subjects, 23 (65.71%) and 12 (34.29%) cases were C. krusei and C. albicans, respectively. Candida krusei was the only non-albicans species found in the HIV-free subjects that was also the predominant isolated species. Regarding the HIV/AIDS patients, the highest prevalence of OPC was observed in the age group of 4150 years. However, in the HIV-free subjects, the age group of 31-40 years had the highest prevalence of this infection. Furthermore, no correlation was observed between the gender and number of Candida isolates. Conclusion: Consideration of the epidemiologic data showed that the two groups were significantly different in terms of the prevalence of Candida species, which could play a major role in the selection of effective drugs for the treatment of candidiasis

CHARACTERISTIC CLINICAL MANIFESTATIONS OF OROPHARYNGEAL CANDIDIASIS IN PATIENTS WITH THE LATE STAGES OF HIV INFECTION

2017 ◽  
Vol 89 (4) ◽  
pp. 97-101
Author(s):  
A. O. Charushin ◽  
◽  
A. M. Elovikov ◽  
I. P. Charushina ◽  
N. N. Vorob’eva ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Clinical Manifestations ◽  
Oropharyngeal Candidiasis ◽  
Late Stages

scholarly journals CLINICAL FEATURES OF THE HIV INFECTION COURSE AND THE DEPENDENCE OF CHANGES IN LABORATORY PARAMETERS ON THE CLINICAL STAGE AND ON THE CD4 LYMPHOCYTES LEVEL

2021 ◽  
Vol 74 (5) ◽  
pp. 1189-1195
Author(s):  
Oksana M. Chemych ◽  
Mykola D. Chemych ◽  
Anna A. Olefir ◽  
Oleh B. Berest
Keyword(s):  
Hiv Infection ◽  
Opportunistic Infections ◽  
Clinical Stage ◽  
Inflammatory Activity ◽  
Clinical Group ◽  
Oropharyngeal Candidiasis ◽  
Endogenous Intoxication ◽  
Criteria For Diagnosis ◽  
Important Objective ◽  
Cd4 Lymphocytes

The aim: Is to determine the features of the HIV infection and changes in indicators of endogenous intoxication and immunoreactivity depending on the clinical stage and the level of CD4 lymphocytes. Materials and methods: 72 HIV-patients were examined. Comparison group included 40 healthy blood donors. Clinical and laboratory examination was performed. Indicators of endogenous intoxication, nonspecific reactivity and inflammatory activity were calculated. Results:Main opportunistic infections were: oropharyngeal candidiasis; tuberculosis of different localization, more often pulmonary tuberculosis; and brain toxoplasmosis (p<0,05). Indices of endogenous intoxication and immunoreactivity are important objective criteria for diagnosis. In groups where the distribution of patients depended on the level of CD4 cells – HIV (CD4≥500) and HIV (CD4≤499-200), index changes were more pronounced than in the HIV I and HIV III groups. The most significant changes in indexes were in the HIV IV clinical group and the HIV (CD4≤199) group: endogenous intoxication indexes were increased by 1,2-7,5 and 1,9-13,7 times in both groups respectively. Non-specific reactivity indexes were decreased by 1,2-1,6 and 1,3-1,6 times, respectively; nuclear index (NI) in groups was 3 and 3,4 times higher (p<0,05–0,001). Changes in indexes of inflammatory activity were observed (p<0,05-0,001). Conclusions: Main diagnosed opportunistic infections were: oropharyngeal candidiasis; tuberculosis of different localization; and brain toxoplasmosis (p<0,05). Indices of endogenous intoxication and immunoreactivity are important objective criteria for diagnosis. The most significant changes in indexes were in the HIV IV clinical group and the HIV (CD4≤199) group (p<0,05-0,001).

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