Characterization of oral candidiasis according to antiretroviral treatment status, immunological and virological profiles among HIV infected patients in two health facilities in Yaoundé-Cameroon: a cross-sectional and analytical study

INTRODUCTION: oral candidiasis in HIV-disease generally indicates immune incompetence both among antiretroviral treatment (ART) naive and experienced patients. To optimize oral healthcare among people living with HIV (PLHIV) in sub-Saharan Africa (SSA), we sought to evaluate the type and distributio...

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Detalles Bibliográficos
Autores principales: Fokam, Joseph, Nka, Alex Durand, Semengue, Ezechiel Ngoufack Jagni, Asso’o, Cynthia Kelly Essono, Gabisa, Jeremiah Efakika, Ka’e, Aude Christelle, Bouba, Yagai, Pabo, Willy, Geh, Buolikeze Kuoh Nji, Gouissi, Davy, Chenwi, Collins Ambe, Tchouaket, Michel Carlos Tommo, Abba, Aissatou, Takou, Désiré, Fainguem, Nadine, Kamgaing, Rachel Simo, Sosso, Samuel Martin, Abena, Marie Elvire Nokam, Ndjolo, Alexis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2023
Materias:
Research
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403771/
https://www.ncbi.nlm.nih.gov/pubmed/37545607
http://dx.doi.org/10.11604/pamj.2023.45.33.33714
Descripción
Sumario:INTRODUCTION: oral candidiasis in HIV-disease generally indicates immune incompetence both among antiretroviral treatment (ART) naive and experienced patients. To optimize oral healthcare among people living with HIV (PLHIV) in sub-Saharan Africa (SSA), we sought to evaluate the type and distribution of oral candidiasis with respect to ART-profile and immuno-virological parameters among PLHIV in the Cameroonian context. METHODS: a cross-sectional study was conducted among 163 patients (51 ART-naïve and 112 ART-experienced) residing in Yaoundé, Cameroon, from February through May 2019. Oral candidiasis was assessed, while viral load (VL) and CD4-count were measured on Abbott m2000rt and Cy-flow counter platforms, respectively. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) v.21 with p<0.05 considered statistically significant. RESULTS: in all, 18 cases of two forms of oral candidiasis were identified (13 erythematous and 5 pseudomembranous), with the majority, 27.7% (11/51), observed among ART-naïve patients against 6.3% (7/112) in ART-experienced (p=0.006). With respect to immuno-virological profile, 77.8% (14/18) and 22.2% (4/18) of cases were identified among participants with CD4<200 cells/mm(3) and CD4>200 cells/mm(3), respectively (p<0.0001). In the light of viral load, the occurrence of oral candidiasis was largely observed among subjects with VL≥1000 copies/ml, 83.3% (15/18), against 16.7% (3/18), with VL<1000 copies/ml, irrespective of the candidiasis form (p<0.0001). CONCLUSION: among PLHIV, erythematous and pseudomembranous candidiasis are commonly found in the absence of ART, driven by immunodeficiency and active viral replication. In spite of the protective role of ART, PLHIV experiencing immuno-virological failure should be referred for management of oral candidiasis.

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