Oropharyngeal Candidiasis in HIV Suspected Patients Attending State Hospital Ijebu-Ode Ogun State Nigeria

Aims: To determine the effect of CD4 count (a glycoprotein found on the surface of immune cells such as T helper cells, monocytes, macrophages and dendritic cells) on the Candida species associated with Oropharyngeal candidiasis among HIV suspected patients.

Place and Duration of the Study: State Hospital Ijebu Ode Ogun State Nigeria between February 2010 to August 2011.

Methodology: Outpatients attending State Hospital Ijebu Ode were screened for HIV infection using Determine kits, Stat-pak kits and Unigold test kits. Western blot was used to confirm HIV infection and to determine the predominance of HIV specific glycoproteins in HIV seropositive patients. A total of 350 samples of sputum and blood from the HIV seropositive individuals while 300 samples from the HIV seronegative individuals. Sputum samples were cultured on sabouraud dextrose agar, and the isolates were Gram stained while the yeast-like fungi were subjected to germ tube test. CD4 count in blood samples was determined using flow cytometry.

Results: HIV prevalence in females was 70.6% and in males was 29.4%. From three hundred and fifty patients suspected as HIV positive, seventy three had oral candidiasis (20.9%) while 277 (79.1%) were candidiasis negative. Higher oral candidiasis occurred in females (22.7%) than in males (16.5%). Candida alblicans was found to have higher occurrence of 86% among other Candida species. There is no significant association between the occurrence of oral candidiasis and the age of HIV subjects. There was higher occurrence of cases of immune depression (<350 CD4 count) in HIV seropositive (56.3%) than in HIV seronegative (0%) subjects. Candida infections occur when CD4 count was 200-500 cell/µl and usually represent the first indication of immune suppression. Decrease in CD4 count led to increase in occurrence of Candida species. The lowest number of Candida species was recorded when CD4 count was above 300 and Candida alblicans is the most predominant species isolated in this study.

Conclusion: The result of this study shows that HIV infection led to decrease in CD4 count which in turn promotes candidiasis.