Factors associated with specific clinical forms of oral candidiasis in HIV-infected Brazilian adults

Abstract Objective This study assesses the association among factors related with specific clinical forms of oral candidiasis (OC) in HIV-infected Brazilian adults. Design This study was conducted with 590 HIV-infected adults from 1997 to 2004. The OC diagnosis was based in accordance with the EC-Clearinghouse classification. Multivariate logistic regression analyses were performed to measure the association between HAART and OC, with pseudomembranous [PC], erythematous [EC], and angular cheilitis [AC]) adjusted for HIV-related diseases, smoking, alcohol consumption, injecting and non-injecting drug use. Results Two hundred and eighteen (37.0%) individuals were undergoing HAART. The prevalence of PC, EC and AC was 21.2%, 15.7% and 8.8%, respectively. Approximately 64% of the individuals with PC and EC, and 76.5% with AC had absolute CD4 levels ≤200 cells/mm3 . The results of the multivariate analysis showed that subjects not undergoing HAART had a significantly higher odds ratio for PC [OR 3.67 (95% CI: 1.97–6.80)] and EC [OR 1.88 (95% CI: 1.04–3.39)], and AC [OR 4.56 (95% CI: 1.58–13.19)]. In addition, smoking [OR 2.58 (95% CI: 1.43–4.68)] and pneumocystis pneumonia [OR 1.92 (95% CI: 1.07–3.42)] were associated with PC, while high alcohol consumption [OR 3.40 (95% CI: 1.13–10.18)] and cytomegalovirus infection [OR 2.34 (95% CI: 1.06–5.15)] were associated with EC. Conclusion The data indicates that the odds of having all clinical forms of OC are higher in HIV-infected adults not receiving HAART.