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Journal of Clinical Microbiology, February 2002, p. 341-350, Vol. 40, No. 2
0095-1137/01/$04.00+0     DOI: 10.1128/JCM.40.2.341-350.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Carriage Frequency, Intensity of Carriage, and Strains of Oral Yeast Species Vary in the Progression to Oral Candidiasis in Human Immunodeficiency Virus-Positive Individuals

Kaaren G. Vargas1* and Sophie Joly1,2

College of Dentistry,1 Department of Biological Sciences, The University of Iowa, Iowa City, Iowa 522422

Received 21 June 2001/ Returned for modification 24 September 2001/ Accepted 7 November 2001

Candida samples were taken over a period of 2 years from 54 human immunodeficiency virus (HIV)-positive asymptomatic subjects to evaluate changes in yeast carriage, intensity of carriage, and genotype over time. Overall, we found that HIV-positive patients with CD4+-cell counts of between 200 and 400/µl had significantly more yeast colonization than healthy control subjects. Of the 54 patients, 11 developed thrush. We found that intensity of carriage in these 11 patients increased significantly in the progression from asymptomatic yeast carrier to an episode of oral thrush. Also, the most common yeast species isolated was Candida albicans; however, we did see a number of patients harboring multiple species at the same time. Using the C. albicans-specific probe Ca3, we found that 54% (n = 6) of the 11 patients who developed thrush maintained genetically similar strains throughout the study period, with minor genetic variations in all patients except one. Forty-six percent of these patients had either multiple strains throughout the study period (n = 2), strain replacement (n = 1), or species replacement (n = 2). Of the patients who had multiple strains, one (I4) was infected by two different strains of Candida dubliniensis distinguished by a recently developed species-specific probe. These results suggest that commensal strains colonizing HIV-positive individuals can undergo alterations prior to producing an episode of thrush.

* Corresponding author. Mailing address: The University of Iowa, College of Dentistry, Dows Institute for Dental Research, Iowa City, IA 52242. Phone: (319) 335-9665. Fax: (319) 335-8895. E-mail: kaaren-g-vargas{at}uiowa.edu.

Journal of Clinical Microbiology, February 2002, p. 341-350, Vol. 40, No. 2
0095-1137/01/$04.00+0     DOI: 10.1128/JCM.40.2.341-350.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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