Prevalence, associated factors and etiologic agents of oral candidiasis among HIV-positive patients in a Vietnamese general hospital

TL;DR

This study examines oral candidiasis in HIV-positive patients in Vietnam, finding a 10.7% prevalence linked to late HIV stage, poor hygiene, and prosthetic use, with Candida albicans being the most common cause.

Contribution

The study provides new insights into the prevalence and causative agents of oral candidiasis in a Vietnamese HIV-positive population.

Findings

Oral candidiasis prevalence was 10.7% among HIV-positive patients.

Candida albicans was the most common species, followed by C. tropicalis.

Non-albicans Candida or mixed infections were frequent in 35.7% of cases.

Abstract

Oral candidiasis (OC) is a common condition in HIV-infected individuals. This study aimed to identify the prevalence, associated factors, and causative agents of OC among HIV-infected patients in a general hospital in Vietnam.

The study involved 393 HIV-infected individuals treated at The Tropical Diseases Center, Nghe An General Friendship Hospital, Vinh, Nghe An, Vietnam from January 2022 to May 2024. The sample collected from the buccal mucosa was
seeded onto CHROMagarTM
Candida to isolate and identify the causative yeasts. Molecular identification was performed with restriction fragment length polymorphism assay using MspI restriction enzyme and sequencing of the internal transcribed spacer (ITS) region

The prevalence of OC was 10.7% (95% confidence interval 7.6 – 13.8). Patients with late WHO HIV clinical stage, poorer hygienic condition, or use of prosthetic were at a higher risk of OC.
Ten yeast species were isolated, and 10 (23.8%) patients carried more than one type of yeast species. Out of 54 obtained isolates, Candida albicans comprised the most (62.9% isolates and 80.9% patients),
followed by C. tropicalis (16.4% and 21.4% respectively).
Overall, 27 patients (64.3%) were infected with C. albicans, and 15 patients (35.7%) were infected with non- albicans Candida, alone or in combination with C. albicans.

The prevalence of OC in HIV-infected patients was low and associated with both systemic and local factors. C. albicans was still the most common
species but non- albicans Candida or coexistence of Candida species is frequent.