Oropharyngeal Candidiasis in HIV-Positive Patients

Oropharyngeal candidiasis is one of the most frequent opportunistic infections affecting the mucosa of the mouth and throat in individuals living with HIV. It arises when immune suppression, most notably the depletion of CD4+ T-cells, permits overgrowth of Candida species—chiefly Candida albicans, but increasingly non-albicans Candida (NAC) species. Clinically, patients may present with white pseudomembranous plaques, erythematous patches or painful ulcerations, often impairing swallowing and nutrition. Despite widespread use of antiretroviral therapy (ART) and implementation of universal test-and-treat policies, oropharyngeal candidiasis continues to occur, reflecting incomplete immune reconstitution and microbial dysbiosis. Biofilm formation on oral mucosa further complicates treatment, contributing to persistence and resistance to azole-class antifungals. Geographic variability in species distribution and antifungal susceptibility underscores the importance of ongoing surveillance. Early recognition and species-level identification guide targeted therapy, while adherence to ART and emerging adjunctive approaches—such as probiotics or novel antifungal formulations—offer avenues to reduce morbidity. Collectively, research efforts aim to refine diagnostic algorithms, characterise resistance mechanisms and develop cost-effective interventions to control this globally significant complication of HIV.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Oropharyngeal Candidiasis in HIV-Positive Patients publication trend

The graph below shows the total number of articles in oropharyngeal candidiasis in hiv-positive patients across all publications each year (not limited to Nature Index journals).

Technical terms

Oropharyngeal candidiasis: Fungal infection of the mouth and throat caused by overgrowth of Candida species in immunocompromised hosts.

CD4+ T-cells: A subset of lymphocytes that orchestrate adaptive immune responses and are selectively depleted by HIV, predisposing to opportunistic infections.

Biofilm: A structured community of microorganisms encased in an extracellular matrix that adheres to mucosal surfaces and confers resistance to antifungal agents.

Non-albicans Candida (NAC): Species of Candida other than Candida albicans, often associated with altered susceptibility profiles and emerging clinical significance.

References

1. Distribution of Candida species isolated from people living with human immunodeficiency virus with oropharyngeal and oral candidiasis in Africa in the era of universal test and treat policy: a systematic review and meta-analysis. Tropical Medicine and Health (2024).
2. Antifungal Susceptibility and Candida sp. Biofilm Production in Clinical Isolates of HIV-Positive Brazilian Patients under HAART Therapy. Biomedicines (2024).
3. Oropharyngeal Candidosis in HIV-Infected Patients—An Update. Frontiers in Microbiology (2018).