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1996-03-04
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Document 0784
DOCN M9640784
TI Opportunistic candidal infections in patients infected with human
immunodeficiency virus: prevention issues and priorities.
DT 9604
AU Reef SE; Mayer KH; Emerging Bacterial and Mycotic Diseases Branch,
Centers for; Disease Control and Prevention, Atlanta, Georgia 30333,
USA.
SO Clin Infect Dis. 1995 Aug;21 Suppl 1:S99-102. Unique Identifier :
AIDSLINE MED/96002835
AB Mucosal candidiasis (oropharyngeal, esophageal, and vulvovaginal
candidiasis) has been among the most prominent opportunistic infections
in persons infected with human immunodeficiency virus (HIV). Esophageal
candidiasis, an AIDS-defining illness, accounted for 15% of the
AIDS-defining illnesses in adults and adolescents diagnosed in the
United States through 1992. The diagnosis of oropharyngeal and vaginal
candidiasis is based on clinically consistent signs and symptoms and a
positive culture or a positive gram, KOH, or calcofluor stain, whereas
the diagnosis of esophageal and pulmonary candidiasis is based on
histopathology. Although a prospective controlled trial showed that
prophylaxis with fluconazole can reduce the risk of mucosal candidiasis
in patients with advanced HIV disease, routine primary prophylaxis is
not recommended because of the effectiveness of therapy for acute
disease, the low mortality associated with mucosal candidiasis, the
potential for development of drug-resistant candidal infection, and the
cost of prophylaxis. The probability of recurrences increases as CD4
counts decline. Nonetheless, many experts do not recommend chronic
prophylaxis to prevent recurrent oropharyngeal and vulvovaginal
candidiasis, for the same reasons that primary prophylaxis is not
recommended. However, if recurrences are frequent or severe following
documented esophageal candidiasis, long-term suppressive therapy with
fluconazole should be considered.
DE AIDS-Related Opportunistic Infections/EPIDEMIOLOGY/*PREVENTION &
CONTROL Candidiasis/EPIDEMIOLOGY/*PREVENTION & CONTROL Female
Forecasting *Health Priorities Human Incidence Male Risk Factors
United States/EPIDEMIOLOGY JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).