ESCMID guideline for the diagnosis and management of Candida Diseases 2012: patients with HIV Infection or AIDS

O. Lortholary, G. Petrikkos, M. Akova, M. Arendrup, S. Arikan-Akdagli, M. Bassetti, J. Bille, T. Calandra, E. Castagnola, O. Cornely, M. Cuenca-Estrella, P. Donnelly, J. Garbino, A. Groll, R. Herbrecht, W.W. Hope, Henrik Elvang Jensen, B.J. Kullberg, C. Lass-Flörl, W. MeerssemanM.D. Richardson, E. Roilides, P.E. Verweij, C. Viscoli, A.J. Ullmann

    54 Citations (Scopus)

    Abstract

    Mucosal candidiasis is frequent in immunocompromised HIV-infected highly active antiretroviral (HAART) naive patients or those who have failed therapy. Mucosal candidiasis is a marker of progressive immune deficiency. Because of the frequently marked and prompt immune reconstitution induced by HAART, there is no recommendation for primary antifungal prophylaxis of mucosal candidiasis in the HIV setting in Europe, although it has been evidenced as effective in the pre-HAART era. Fluconazole remains the first line of therapy for both oropharyngeal candidiasis and oesophageal candidiasis and should be preferred to itraconazole oral solution (or capsules when not available) due to fewer side effects. For patients who still present with fluconazole-refractory mucosal candidiasis, oral treatment with any other azole should be preferred based on precise Candida species identification and susceptibility testing results in addition to the optimization of HAART when feasible. For vaginal candidiasis, topical therapy is preferred.

    Original languageEnglish
    JournalClinical Microbiology and Infection
    Volume18
    Issue numberSuppl. s7
    Pages (from-to)68-77
    Number of pages10
    ISSN1198-743X
    DOIs
    Publication statusPublished - Dec 2012

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