Anti-retroviral therapy with protease inhibitors decreases virulence enzyme expression in vivo by Candida albicans without selection of avirulent fungus strains or decreasing their anti-mycotic susceptibility

FEMS Immunol Med Microbiol. 2004 May 1;41(1):27-34. doi: 10.1016/j.femsim.2003.12.006.

Abstract

Highly active anti-retroviral therapies (HAART) with human immunodeficiency virus (HIV) protease inhibitors (PIs) or nonnucleoside reverse-transcriptase inhibitors (NNRTI) were compared for their effect on prevalence, aspartyl proteinase (Sap) production and the biotypes and anti-mycotic sequential susceptibility of Candida spp. isolates from the oral cavity in a longitudinal prospective study. HAART-PI, but not HAART-NNRTI strongly inhibited Sap expression in the oral cavity without exerting any consistent effect on the role of Candida spp. isolation or selection of low virulence or anti-mycotic resistant fungus biotype. More importantly, the sequential isolates of Candida albicans from HAART-PI, but not those from suspended HAART-NNRTI, showed an increased Sap production in vitro. While further demonstrating that HIV-PI inhibit Sap expressions, our results do not support the view that the mentioned inhibition could eliminate Candida or its selection of the oral cavity.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy
  • Adult
  • Antiretroviral Therapy, Highly Active*
  • Aspartic Acid Endopeptidases / metabolism*
  • Candida / drug effects*
  • Candida / enzymology
  • Candida / isolation & purification
  • Candida / pathogenicity
  • Candidiasis, Oral / drug therapy*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV Protease Inhibitors / therapeutic use*
  • Humans
  • Longitudinal Studies
  • Male
  • Oropharynx / microbiology
  • Reverse Transcriptase Inhibitors / therapeutic use
  • Saliva / microbiology
  • Virulence

Substances

  • HIV Protease Inhibitors
  • Reverse Transcriptase Inhibitors
  • Aspartic Acid Endopeptidases