Prevalence of vaginal infection by candida subtypes in women with HIV compared to the control group and influence of immune status

Authors

  • Somaia Reda Universidade Federal do Paraná – Curitiba (PR), Brazil. https://orcid.org/0000-0002-6008-9938
  • Ana Cecília Pedriali Guimarães Spautz Universidade Federal do Paraná – Curitiba (PR), Brazil.
  • Isabela Gil Universidade Positivo – Curitiba (PR), Brazil.
  • Maria Victoria Fujii Kato Universidade Positivo – Curitiba (PR), Brazil.
  • Elizabeth Souza Frade Coltro Hospital de Clínicas da Universidade Federal do Paraná – Curitiba (PR), Brazil.
  • Mariana Hiromi Azuma Hospital de Clínicas da Universidade Federal do Paraná – Curitiba (PR), Brazil.
  • Viviane Obialski Universidade Federal do Paraná – Curitiba (PR), Brazil. https://orcid.org/0009-0002-6799-6271
  • Newton Sérgio De Carvalho Universidade Federal do Paraná – Curitiba (PR), Brazil. https://orcid.org/0000-0001-7561-4566

DOI:

https://doi.org/10.5327/DST-2177-8264-2023351393

Keywords:

Candida sp., HIV, viral load, TCD4

Abstract

Introduction: Vulvovaginal candidiasis (VVC), caused by Candida sp, may present with increased frequency and symptoms in immunocompromised patients, and there is concern about the diagnosis and adequate treatment of these patients. Objective: The aim of this study was to evaluate the prevalence of VVC compared to the immune status and species present in the microbiota of patients with HIV. Methods: This cross-sectional study was conducted from January 2017 to January 2018, including 97 women with HIV compared to a control group (n=112). For data collection, interviews were conducted, vaginal pH was measured, CD4+ T cells and viral load (VL) were evaluated, and vaginal secretions were collected for microscopy and culture. Results: The prevalence of VVC was 41.2% in seropositive patients and 3.6% in the control group (p<0.001). Of the patients with CD4+<200 T, 54.3% had Candida sp, while in those with CD4+ T ³200 cells/mm³, the prevalence was 33.9% (p=0.057). Regarding viral load, the prevalence of VVC was 24.1% in those with undetectable VL or <20, 50% in those with VL between 20 and 9999, and 46.9% in VL above 10000 copies/mL (p=0.08). The most prevalent species were Candida albicans, followed by C. parapsilosis, C. krusei, and C. glabrata. The mean vaginal pH was 4.6 in the control group and 5.2 in the case group. Conclusion: HIV-positive women have a higher prevalence of candida. Lower T CD4+ values and increased VL seem to be associated with a higher prevalence of infection.

Downloads

Download data is not yet available.

References

Lamont RF, Sobel JD, Akins RA, Hassan SS, Chaiworapongsa T, Kusanovic JP, et al. The vaginal microbiome: new information about genital tract flora using molecular based techniques. BJOG. 2011;118(5):533-49. https://doi.org/10.1111/j.1471-0528.2010.02840.x

Gopinath S, Iwasaki A. Cervicovaginal microbiota: simple is better. Immunity. 2015;42(5):790-1. https://doi.org/10.1016/j.immuni.2015.05.006

Linhares IM, Giraldo PC, Baracat EC. Novos conhecimentos sobre a flora bacteriana vaginal. Rev Assoc Med Bras. 2010;56(3):370-4. https://doi.org/10.1590/S0104-42302010000300026

Martinez RC, Franceschini SA, Patta MC, Quintana SM, Nunes AC, Moreira JL, et al. Analysis of vaginal lactobacilli from healthy and infected Brazilian women. Appl Environ Microbiol. 2008;74(14):4539-42. https://doi.org/10.1128/AEM.00284-08

Spinillo A, Michelone G, Cavanna C, Colonna L, Capuzzo E, Nicola S. Clinical and microbiological characteristics of symptomatic vulvovaginal candidiasis in HIV-seropositive women. Genitourin Med. 1994;70(4):268-72. https://doi.org/10.1136/sti.70.4.268

Ohmit SE, Sobel JD, Schuman P, Duerr A, Mayer K, Rompalo A, et al. Longitudinal study of mucosal Candida species colonization and candidiasis among human immunodeficiency virus (HIV)–seropositive and at‐risk HIV‐seronegative women. J Infect Dis. 2003;188(1):118-27. https://doi.org/10.1086/375746

Reed BD, Gorenflo DW, Gillespie BW, Pierson CL, Zazove P. Sexual behaviors and other risk factors for Candida vulvovaginitis. J Womens Health Gend Based Med. 2000;9(6):645-55. https://doi.org/10.1089/15246090050118170

Nunes E. Consumo de tabaco. Efeitos na saúde. Rev Port Med Geral Fam. 2006;22(2):225-44. https://doi.org/10.32385/rpmgf.v22i2.10231

Centro Brasileiro de Informações sobre Drogas Psicotrópicas. As drogas e a AIDS [Internet]. [cited on 2023 Oct 25]. Available from: http://www2.unifesp.br/dpsicobio/cebrid/quest_drogas/drogas_aids.htm

Esebelahie NO, Enweani IB, Omoregie R. Candida colonisation in asymptomatic HIV patients attending a tertiary hospital in Benin City, Nigeria. Libyan J Med. 2013;8(1):20322. https://doi.org/10.3402/ljm.v8i0.20322

Apalata T, Carr WH, Sturm WA, Longo-Mbenza B, Moodley P. Determinants of symptomatic vulvovaginal candidiasis among human immunodeficiency virus type 1 infected women in rural KwaZulu-Natal, South Africa. Infect Dis Obstet Gynecol. 2014;2014:387070. https://doi.org/10.1155/2014/387070

Sobel JD. Vulvovaginal candidiasis: a comparison of HIV-positive and -negative women. Int J STD AIDS. 2002;13(6):358-62. https://doi.org/10.1258/095646202760029741

Fornari G, Vicente VA, Gomes RR, Muro MD, Pinheiro RL, Ferrari C, et al. Susceptibility and molecular characterization of Candida species from patients with vulvovaginitis. Braz J Microbiol. 2016;47(2):373-80. https://doi.org/10.1016/j.bjm.2016.01.005

Badiee P, Alborzi A, Davarpanah MA, Shakiba E. Distributions and antifungal susceptibility of Candida species from mucosal sites in HIV positive patients. Arch Iran Med. 2010;13(4):282-7. PMID: 20597560

Seeniammal S, Selvakumar M, Nirmaladevi P. Clinicomycological study of vulvovaginal candidiasis. Indian J Sex Transm Dis AIDS. 2021;42:57-61. https://doi.org/10.4103/ijstd.IJSTD_49_18

Oliveira PM, Mascarenhas RE, Lacroix C, Ferrer SR, Oliveira RPC, Cravo EA, et al. Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil. Braz J Infect Dis. 2011;15(3):239-44. https://doi.org/10.1016/s1413-8670(11)70182-9

Rodrigues CR, Lenicov FR, Jancic C, Sabatté J, Cabrini M, Ceballos A, et al. Candida albicans delays HIV-1 replication in macrophages. PLoS One. 2013;8(8):e72814. https://doi.org/10.1371/journal.pone.0072814

Shifrin E, Matityahu D, Feldman J, Minkoff H. Determinants of incident vulvovaginal candidiasis in human immunodeficiency virus-positive women. Infect Dis Obstet Gynecol. 2000;8(3-4):176-80. https://doi.org/10.1155/S1064744900000247

Downloads

Published

2023-12-01

How to Cite

1.
Reda S, Spautz ACPG, Gil I, Kato MVF, Coltro ESF, Azuma MH, Obialski V, De Carvalho NS. Prevalence of vaginal infection by candida subtypes in women with HIV compared to the control group and influence of immune status. DST [Internet]. 2023 Dec. 1 [cited 2024 Feb. 21];35. Available from: https://bjstd.org/revista/article/view/1393

Issue

Section

Original Article