Epidemiology of Oral Candida Infection among People Living With HIV/AIDS (PLWHA) in Bida, Niger State, Nigeria.

Abstract

Oropharyngeal candidiasis is a common occurrence in the course of Human Immunodeficiency Virus (HIV) disease progression and it is predictive of immunosuppression. Against the background of the paucity of data on the epidemiology of candida infection among People Living With HIV/AIDS (PLWHA) in Bida, Niger State, Nigeria, the study was conducted. The study is a prospective and epidemiological survey carried out on HIV positive patients attending ART clinic in Federal Medical Centre, Bida. Oral swabs were collected and cultured for the isolation of candida and speciation of isolate was done using Chromagar candida. The CD4+ cell counts of all the subjects were estimated using the Partec Cyflow Counter 2 and correlated with presence or absence of candidiasis. Out of a total of the 390 HIV positive   patients, 116 (29.8%) yielded growth of candida species with the distribution of Candida albicans 77(66.4%), Candida tropicalis 26(22.4%), Candida krusei 12(10.3%) and a mixed growth of Candida albicans and Candida tropicalis 1(0.9%). There was a statistically significant difference between oral candidiasis (Candida albicans) and CD4+ count < 50 cells/µl (p=0.0030). The study however found out that patients with moderate and high CD4+ count (>200 to 1000 cells/ µl) are also susceptible and have the chances of developing oral candidiasis. Candida albicans was the most common specie of oral candidiasis among the HIV/AIDS subjects in Bida. There was no statistical significance between oral candidiasis and duration HIV infection. The study revealed that Candida albicans, Candida tropicalis and Candida krusei are the species causing oropharyngeal candidiasis among People Living With HIV/AIDS. An overall oropharyngeal candidiasis prevalence of 29.8% was observed among the studied population. CD4+ count <200cell/µl is not a risk factor for acquiring oropharyngeal candidiasis.