Candidiasis.

Oropharyngeal candidiasis has been one of the main features of HIV infection since AIDS has been known as a disease, but attention to it has been downplayed since many other opportunistic infections are more life-threatening. Candidiasis greatly impacts patients' quality of life and more treatments need to be developed to overcome recurrent cases. Diagnosis of the most common forms of candidiasis, i.e., oral and vaginal, is not difficult, and may be treated locally initially, then systemically. Antifungal agents for oral or esophageal candidiasis may include nystatin, clotrimazole, ketoconazole, fluconazole, itraconazole, or amphotericin B; vulvovaginal disease is treated with clotrimazole, miconazole, or butoconazole in cream or suppository form. Since relapses are a concern, patients with CD4 counts less than 200 may be treated with fluconazole, although this drug may interact with treatment for other opportunistic infections. In cases of fluconazole-resistant candidiasis, treatment with the other previously-listed antifungal agents may be tried.