       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).

