Oral candidal colonisation has been reported to range from approximately 40% to 70% of healthy children and adults, with higher rates observed among children with carious teeth and older adults wearing dentures.[6]Daniluk T, Tokajuk G, Stokowska W, et al. Occurrence rate of oral Candida albicans in denture wearer patients. Adv Med Sci. 2006;51(suppl 1):77-80.
http://www.ncbi.nlm.nih.gov/pubmed/17458064?tool=bestpractice.com
[7]Lyon JP, da Costa SC, Totti VM, et al. Predisposing conditions for Candida spp. carriage in the oral cavity of denture wearers and individuals with natural teeth. Can J Microbiol. 2006 May;52(5):462-7.
http://www.ncbi.nlm.nih.gov/pubmed/16699571?tool=bestpractice.com
[8]Rozkiewicz D, Daniluk T, Zaremba ML,et al. Oral Candida albicans carriage in healthy preschool and school children. Adv Med Sci. 2006;51(suppl 1):187-90.
http://www.ncbi.nlm.nih.gov/pubmed/17458089?tool=bestpractice.com
Candida carriage rate has been shown to also increase with cancer radiation therapy, diabetes, and HIV infection.[9]Stokman MA, Spijkervet FK, Burlage FR,et al. Oral mucositis and selective elimination of oral flora in head and neck cancer patients receiving radiotherapy: a double-blind randomised clinical trial. Br J Cancer. 2003 Apr 7;88(7):1012-6.
https://www.nature.com/articles/6600824
http://www.ncbi.nlm.nih.gov/pubmed/12671696?tool=bestpractice.com
[10]Tapper-Jones LM, Aldred MJ, Walker DM, et al. Candidal infections and populations of Candida albicans in mouths of diabetics. J Clin Pathol. 1981 Jul;34(7):706-11.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC493798/pdf/jclinpath00488-0012.pdf
http://www.ncbi.nlm.nih.gov/pubmed/7021599?tool=bestpractice.com
[11]Campisi G, Pizzo G, Milici ME, et al. Candidal carriage in the oral cavity of human immunodeficiency virus-infected subjects. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Mar;93(3):281-6.
http://www.ncbi.nlm.nih.gov/pubmed/11925537?tool=bestpractice.com
[12]Erkose G, Erturan Z. Oral Candida colonization of human immunodeficiency virus infected subjects in Turkey and its relation with viral load and CD4+ T-lymphocyte count. Mycoses. 2007 Nov;50(6):485-90.
http://www.ncbi.nlm.nih.gov/pubmed/17944711?tool=bestpractice.com
Candida colonisation may lead to opportunistic mucosal infection as well as disseminated and multi-system organ involvement in immunocompromised people. The rate of infection has been reported as 50% during chemotherapy, 70% during radiation therapy, and 90% in HIV infection.[13]Reichart PA. Oral manifestations in HIV infection: fungal and bacterial infections, Kaposi's sarcoma. Med Microbiol Immunol. 2003 Aug;192(3):165-9.
http://www.ncbi.nlm.nih.gov/pubmed/12684760?tool=bestpractice.com
[14]Soysa NS, Samaranayake LP, Ellepola AN. Cytotoxic drugs, radiotherapy and oral candidiasis. Oral Oncol. 2004 Nov;40(10):971-8.
http://www.ncbi.nlm.nih.gov/pubmed/15509487?tool=bestpractice.com
Antifungal agents are often used during radiation and chemotherapy to prevent opportunistic infection among patients receiving treatment for cancer.[15]Ship JA, Vissink A, Challacombe SJ. Use of prophylactic antifungals in the immunocompromised host. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Mar;103(suppl 6):e1-14.
http://www.ncbi.nlm.nih.gov/pubmed/17379157?tool=bestpractice.com
In addition, the introduction of highly active antiretroviral therapy has led to a decrease in the incidence of oral candidiasis and cases of refractory diseases among people living with HIV.[16]Patton LL, McKaig R, Stauss R, et al. Changing prevalence of oral manifestations of human immuno-deficiency virus in the era of protease inhibitor therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Mar;89(3):299-304.
http://www.ncbi.nlm.nih.gov/pubmed/10710453?tool=bestpractice.com
[17]National Institutes of Health, Centers for Disease Control and Prevention, HIV Medicine Association of the Infectious Diseases Society of America. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: Candidiasis (mucocutaneous). 2020 [internet publication].
https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/candidiasis-0
[18]Patel PK, Erlandsen JE, Kirkpatrick WR, et al. The changing epidemiology of oropharyngeal candidiasis in patients with HIV/AIDS in the era of antiretroviral therapy. AIDS Res Treat. 2012;2012:262471.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3434376
http://www.ncbi.nlm.nih.gov/pubmed/22970352?tool=bestpractice.com
The beneficial effect of antiretrovirals may be through their effect on immune recovery and lower oropharyngeal colonisation of Candida species or a direct inhibitory effect on the yeast organisms.[19]Gottfredsson M, Cox GM, Indridason OS, et al. Association of plasma levels of human immunodeficiency virus type 1 RNA and oropharyngeal Candida colonization. J Infect Dis. 1999 Aug;180(2):534-7.
http://jid.oxfordjournals.org/content/180/2/534.full
http://www.ncbi.nlm.nih.gov/pubmed/10395877?tool=bestpractice.com
[20]Korting, HC, Schaller M, Eder G, et al. Effects of the human immunodeficiency virus (HIV) proteinase inhibitors saquinavir and indinavir on in vitro activities of secreted aspartyl proteinases of Candida albicans isolates from HIV-infected patients. Antimicrob Agents Chemother. 1999 Aug;43(8):2038-42.
http://aac.asm.org/cgi/content/full/43/8/2038
http://www.ncbi.nlm.nih.gov/pubmed/10428932?tool=bestpractice.com
[21]de Repentigny L, Lewandowski D, Jolicoeur. Immunopathogenesis of oropharyngeal candidiasis in human immunodeficiency virus infection. Clin Microbiol Rev. 2004 Oct;17(4):729-59.
http://cmr.asm.org/cgi/content/full/17/4/729
http://www.ncbi.nlm.nih.gov/pubmed/15489345?tool=bestpractice.com