Mario P. Mensana, - and Diah S. Ernawati, - and Alexander Patera Nugraha, - and Bagus Soebadi, - and Erwin Astha Triyono, - and Dominicus Husada, - and Remita A. Prasetyo, - and Sulistyowati B. Utami, - and Irna Sufiawati, - (2018) Oral candidiasis profile of the Indonesian HIV-infected pediatric patients at UPIPI Dr. Soetomo General Hospital, Surabaya, Indonesia. The Southeast Asian Journal of Tropical Medicine and Public Health, 17 (4). pp. 272-277. ISSN 1732-2707

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Abstract

Introduction Indonesia is stated as one of Asia’s fastest growing HIV epidemics, yet to date, studies on the characteristics of human immunodeficiency virus (HIV) infection, especially on Indonesian children, are very limited. Opportunistic infections, such as oral candidiasis have been an integral part of the disease and related to important diagnostic and prognostic values of the infection. The aim of this study was to determine the candidiasis profile of the Indonesian HIV-infected pediatric patients, and to correlate the clinical types of candidiasis with highly active antiretroviral therapy (HAART) use and the level of immune suppression. Material and methods HIV-infected pediatric patients attending the Intermediate Care and Infectious Disease Centre (UPIPI), Dr. Soetomo Hospital outpatient clinic between June-October 2017 were examined intraorally for the presence of oral candidiasis. Identification of Candida species was based on colony morphology on CHROM-Agar, hydrolysis of urea, carbohydrate fermentation tests, thermotolerance test, and microscopic morphology on slide culture from oral swab samples. Other relevant data regarding each patient were also obtained from medical records. Results Oral candidiasis was found in 55.17% patients, with 3 different clinical types: pseudomembranous (21.43%), erythematous (14.29%), and angular cheilitis (46.3%). There was a significant relationship between HAART with erythematous type (p < 0.05) and even stronger with the pseudomembranous type of Candida (p < 0.01). There was significant relationship between the level of immune suppression and pseudomembranous type (p < 0.05) and even stronger with the erythematous type (p < 0.01). Conclusions Concurrent pseudomembranous and erythematous candidiasis may indicate advanced progression of HIV-infected pediatric patients, therefore further studies are required to validate our findings.

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