Pulmonary candidiasis and CD4 count in HIV positive patients seen in Jos, north central Nigeria

Abstract

Background: Accurate and reliable diagnosis of HIV opportunistic infections plays a central role in effective HIV intervention programmes. Pulmonary infections are the leading cause of  morbidity and mortality in HIV infected individuals.

Objectives: We set out to determine the prevalence of Pulmonary candidiasis by isolating Candida species from the sputum of HIV sero-positive patient’s presenting to hospital with complaint of cough for more than two weeks and related the level of CD₄ count to Pulmonary candidiasis.

Methods: Using sterile wire loop, each sputum sample was inoculated into duplicate SDA (Thermo Scientific, UK); one tube without antibiotics, another tube supplemented with Chloramphenicol (0.05%) and Cycloheximide (0.5%) antibiotics. The patient’s CD₄ count was determined using a Cyflow machine (PARTECR, Germany).

Result: Fifty two (54.2%) female and 44(45.8%) male HIV positive subjects were compared with a control group made up of, 52(54.2%) female and 44(45.8%) male HIV negative subjects. Twenty one (21.9%) HIV positive subjects had Candida species in their sputum samples compared to 12(12.5%) in the HIV negative subjects. Among HIV positive subjects, 17(17.7%) had Candida albicans isolated from their sputum, 11(11.5%) of whom had a CD₄ count of <200 cells/ul.

Conclusion: We concluded that, there is a risk of pulmonary candidiasis occurring in HIV infected patients with CD₄ count <200cells/ul and that, Candida species contributes to chronic cough experienced by HIV infected patients. We recommend that HIV positive patients who have chronic cough and whose CD₄ count is <200cells/ul be placed on systemic antifungal medication.

Keywords: Candida, Cough, Nigeria, Sputum