DECLINING RATES OF OROPHARYNGEAL CANDIDIASIS AND CARRIAGE OF CANDIDA-ALBICANS ASSOCIATED WITH TRENDS TOWARD REDUCED RATES OF CARRIAGE OF FLUCONAZOLE-RESISTANT CANDIDA-ALBICANS IN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED PATIENTS

In order to determine the current prevalence and incidence of fluconaz ole-resistant oropharyngeal candidiasis among human immunodeficiency v irus (HIV)-infected patients, we conducted a prospective observational study of a consecutive series of HPV-infected patients. Of 128 enroll ed patients, 70 patients completed four quarterly follow-up visits ove r a period of 1 year. Over this period, declining rates of carriage of Candida albicans (from 61% to 39%; P = .008) and of oropharyngeal can didiasis (from 30% to 4%; P < .001) were documented. Il:rends toward r eduction in the frequency of fluconazole-resistant isolates (MIC, grea ter than or equal to 64 mu g/mL) were also seen. During the survey per iod, the mean (median) number of antiretroviral agents used per patien t rose from 0.5 (0) to 1.8 (2) (P < .001). Thus, rather than progressi on, we observed declining rates of oropharyngeal candidiasis, C. albic ans carriage, and fluconazole-resistant C. albicans in a cohort of HIV -infected patients treated with increasingly effective antiretroviral therapy.