Refractory Mucosal Candidiasis in Advanced Human Immunodeficiency Virus Infection

We conducted a multicenter, prospective study of the risk factors, natural history, and outcome of fluconazole-refractory mucosal candidiasis (FRMC) in 832 persons with advanced human immunodeficiency virus (HIV) infection (median CD4 cell count, 14/mm3) during 1994–1996. FRMC was defined as mucosal...

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Bibliographic Details
Published in:Clinical infectious diseases 2000-05, Vol.30 (5), p.749-756
Main Authors: Fichtenbaum, Carl J., Koletar, Susan, Yiannoutsos, Constantin, Holland, Fiona, Pottage, John, Cohn, Susan E., Walawander, Ann, Frame, Peter, Feinberg, Judith, Saag, Michael, Van der Horst, Charles, Powderly, William G.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
AIDS
AIDS-Related Opportunistic Infections - epidemiology
AIDS-Related Opportunistic Infections - microbiology
AIDS/HIV
Antifungal Agents - therapeutic use
Biological and medical sciences
Candida - classification
Candida - isolation & purification
Candidiasis
Candidiasis, Oral - drug therapy
Candidiasis, Oral - epidemiology
Candidiasis, Oral - microbiology
Clinical Articles
Cytomegalovirus
Dosage
Esophagitis - drug therapy
Esophagitis - epidemiology
Esophagitis - microbiology
Female
Fluconazole - therapeutic use
Fungal infections
HIV
HIV infections
Human immunodeficiency virus
Human viral diseases
Humans
Incidence
Infections
Infectious diseases
Male
Medical sciences
Middle Aged
Mycobacterium avium complex
Oral candidiasis
Prospective Studies
Risk Factors
Treatment Failure
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:We conducted a multicenter, prospective study of the risk factors, natural history, and outcome of fluconazole-refractory mucosal candidiasis (FRMC) in 832 persons with advanced human immunodeficiency virus (HIV) infection (median CD4 cell count, 14/mm3) during 1994–1996. FRMC was defined as mucosal candidiasis that failed to resolve despite 14 days of therapy with daily doses (≥200 mg) of fluconazole. Thirty-six persons (4.3%) had FRMC (35, oral; 1, esophageal), for an incidence of 4.2 per 100 person-years (859.7 total years of follow-up). In a multivariate model, the use of trimethoprim-sulfamethoxazole within 6 months of enrollment (relative risk [RR], 2.39; P = .04) and the use of fluconazole daily or every other day (RR, 5.64; P = .004) were significantly associated with the development of FRMC. The median survival after the development of FRMC was 32.6 weeks. In conclusion, the annual incidence of FRMC was
ISSN:1058-4838
1537-6591
DOI:10.1086/313765