Subgingival biofilm colonization by Candida albicans and Candida dubliniensis in patients living with HIV from Buenos Aires, Argentina.

Abstract

Oropharyngeal candidiasis (OC) is common among people living with HIV (PLWH). Persistent colonization of oral epithelial surfaces serves as an ecological niche for opportunistic pathogens and is a significant predisposing factor for OC development in PLWH. Mucosal colonization can lead to biofilm formation, directly impacting oral epithelium.

Aim: To assess Candida albicans and Candida dubliniensis colonization in subgingival biofilms of people living with HIV (PLWH) and undergoing antiretroviral therapy (ART).

Materials and method: A sample of 51 PLWH who were receiving ART was studied, focusing on dental and periodontal parameters. Subgingival biofilm and mucosa samples were collected, and Candida spp. were identified using molecular techniques.

Results: Men (average age: 41.11 ± 8.63) predominated. The main cause of HIV was sexual transmission. Fungal-related opportunistic diseases were observed in 18 patients, and LT CD4 counts were evaluated. A total 255 samples were collected, including 204 from gingivoperiodontal sites and 51 from oral mucosa. Candida spp. was detected in 55% of patients, with particular distribution patterns. Positive Candida spp. presence correlated with clinical attachment level and HIV treatments. Microscopic identification revealed the presence of hyphae at the time of microbiological sample collection. Molecular identification confirmed 16 Candida albicans and 36 Candida dubliniensis isolates, challenging their diagnostic importance.

Conclusions: The presence of yeast hyphae/pseudohyphae in subgingival biofilms indicates their role in gingivo-periodontal disease dysbiosis. PLWH in this Argentine region face challenges including limited access to healthcare. The study underscores the need for early oral health intervention, emphasizing the diagnostic significance of Candida.