Oropharyngeal candidiasis in patients with HIV: Suggested guidelines for therapy

William G. Powderly, Joel E. Gallant, Mahmoud A. Ghannoum, Kenneth H. Mayer, Eileen E. Navarro, John R. Perfect

Research output: Contribution to journalReview articlepeer-review

37 Scopus citations

Abstract

The high frequency of oropharyngeal candidiasis in immunocompromised patients has led many institutions to develop protocols to guide the use of antifungal agents in the treatment of this opportunistic infection. However, few specific recommendations have been made for directing the management of oropharyngeal candidiasis in patients infected with HIV. To meet this need, a panel of experts representing a variety of disciplines met to formulate a consensus and devise a treatment strategy for clinical application. Among other recommendations, the algorithm calls for use of a topical agent for the treatment of initial and recurring oropharyngeal candidiasis in HIV-infected patients, provided there is no esophageal involvement, patients' CD4+ lymphocyte cell count is >50 cells/mm3, and they are currently receiving or expected to receive effective antiretroviral treatment. For episodes of oropharyngeal candidiasis with concurrent esophageal involvement or where patients have a CD4+ cell count of <50 cells/mm3, are not receiving or anticipating highly active antiretroviral therapy (HAART), and have a high viral load, the algorithm suggests a systemic oral azole as the more appropriate treatment choice. Acute treatment of all oropharyngeal candidiasis episodes is preferred. Chronic suppressive antifungal treatment is to be avoided in recognition of the potential for the development of drug- resistant infection.

Original languageEnglish
Pages (from-to)1619-1623
Number of pages5
JournalAIDS research and human retroviruses
Volume15
Issue number18
DOIs
StatePublished - Dec 10 1999

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