Candida-specific systemic cell-mediated immune reactivities in human immunodeficiency virus-positive persons with mucosal candidiasis

Oropharyngeal candidiasis (OPC), as opposed to vulvovaginal candidiasis (VV C), is a common opportunistic infection in human immunodeficiency virus (HI V)- positive persons that correlates with reduced CD4 T cell counts. Althou gh cell- mediated immunity (CMI) by CD4 Th1- type cells is considered to be the predominant host defense against mucosal candidiasis, the immune facto rs associated with susceptibility to OPC in HIV- positive persons are not w ell understood. This study investigated Candida- specific systemic CMI in H IV- positive persons with OPC and/or VVC. Reductions in delayed skin test r eactivity to Candida antigen were observed in HIV- positive persons with CD 4 cell counts <200 cells/<mu>L, irrespective of the presence of mucosal inf ection. Likewise, despite the correlate of OPC with reduced CD4 cell counts in HIV- positive persons, differences in Candida- specific peripheral bloo d mononuclear cell proliferation and Th1/Th2 cytokine production between HI V- positive and HIV- negative persons were not consistent in a manner to su ggest that deficiencies in Candida- specific systemic CMI account solely fo r the susceptibility to OPC.