Intractable Oral Candidosis As An Indicator Of HIV Infection In Infants
AbstractObjective: Human immunodeficiency virus infection is assuming an epidemic proportion in the developing world, and infants are increasingly being infected and seen with clinical features and serological evidence of HIV infection in IIorin. Intractable oral candidosis is one of the clinical features of the disease seen commonly infants. This study examined the possible association between intractable oral thrush and HIV infections in infancy
Design: This is a prospective study carried out over a 3 year period.
Subjects & Method: Infants presenting with oral candidosis who did not respond to two courses of oral mycostatin drop given thrice daily over 2 weeks period were studied. Such infects were screened for HIV infection after parental consent. Another group of infants who did not have oral candidosis but were screened for HIV infection due to other indication served as controls for the purpose of comparison.
Results: Thirty two infants with intractable oral candidosis were screened and 28 (87.5%) were HIV positive whilst 2 out of 20 (10%) cases without intractable oral candidosis screened other reasons were positive for HIV infection (X2 = 21.48, p=0.000036, odds ratio = 24.54 “RR” = 5.42).
The presence of intractable oral cadidosis in HIV infected infants has a sensitivity of 93.3% and specificity of 81.8%, with a positive predictive vale of 85.3%. The oral lesions cleared completely with oral miconazole gel given thrice daily for two weeks
Conclusion: The finding of extensive intractable oral candidosis which is refractory to simple oral antifungal agent therapy in infants should raise the suspicion of HIV infection and such infants should be screened for HIV after parental consent
KEY WORDS: Intractable oral thrush, infants, HIV infection, miconazole gel
Nigerian Journal of Clinical Practice Vol.6(1) 2003: 42-45