Oral Fungal Carriage in HIV-Infected Individuals

Objective: To compare fungal carriage in saliva and gingival crevicular fluid (GCF) between HIV-infected and HIV-negative individuals.

Method: 123 HIV- infected individuals, included 72 males and 51 females, mean age ± SD 40.59±11.08 with 266 age and sex matched controls (Group1). Saliva and GCF were collected and cultured for fungus. 10 minute unstimulated whole salivary flow, saliva pH and GCF were measured. The fungal carriage of GCF, plaque index (PLI), probing depth (PD), bleeding index (BI) and attachment loss (AL) were recorded and compared with 89 individuals with age and sex matched HIV-negative controls (group2).

Results: In the AIDS/HIV group, the fungal carriage was 30.1% (37/123) in saliva and 18.0% (22/122) in GCF. The prevalence of oral candidiasis 11.4% (14/123). They were all significantly higher than those in the control groups (P<0.05). In our study, the carriage of fungi in saliva and GCF was not associated with CD4+ count, HAART therapy or anti-fungal agents. Although the fungal carriage in saliva was not associated with salivary pH, the incidence of GCF fungal carriage increased with decreasing pH and increase in fungal colonies in saliva. PLI and AL were positively correlated with fungal carriage in GCF. Candida albicans the most common species isolated in both saliva and GCF, with no significant difference between the two groups.

Conclusion: The high prevalence of fungal cariage in saliva and GCF in HIV-infected individuals may associate with systemic immunosuppression. However the presence of fungi in GCF is not associated with HIV-related periodontal disease.