Document 2977
 DOCN  M94A2977
 TI    Prognostic value of fluconazole response patterns in HIV infected
       patients with oropharyngeal candidosis.
 DT    9412
 AU    Diz DP; Miralles C; Ocampo A; Feujoo JF; Sopena B; De la Fuente J;
       Martinez C; Xeral-Cies Hospital, Vigo, Spain.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):181 (abstract no. PB0149). Unique
       Identifier : AIDSLINE ICA10/94369598
 AB    OBJECTIVE: To establish a relation between HIV infection evolution and
       fluconazole response patterns in HIV-positive patients with
       oropharyngeal candidosis. METHODS: In a prospective study a 30
       HIV-positive cohort with clinical and microbiological confirmed
       oropharyngeal candidosis, received fluconazole therapy (100 mg. per
       day). In vitro antifungal susceptibility tests demonstrated lack of
       fluconazole resistency. Cultures of mouth swabs were performed at the
       end of therapy and two weeks later. During 6 months, a clinical
       followi-up of the 30 patients was carried out. RESULTS: Clinical and
       microbiological cure was achieved in 26 patients. In 10 of these 26,
       cultures remained negative after two weeks (pattern A), most of them
       with CD4 > 400/ml. In the remaining 16, cultures detected
       microbiological relapse two weeks after treatment (pattern B). In spite
       of clinical improvement, treatment failure was observed in 4 patients
       (pattern C), all of them with CD4 lymphocyte count < 50/ml. In a 6 month
       period, 5 patients presented some AIDS-defining event (4 with pattern B
       and 1 with C) and 3 patients died (the 3 remainder with pattern C).
       CONCLUSION: The lack of response to fluconazole may represent a complete
       failure in the immunitary system and it could be considered a predictor
       of fatal evolution. (At the Conference, results after one year of follow
       up will be discussed).
 DE    AIDS-Related Opportunistic Infections/*DRUG THERAPY/IMMUNOLOGY
       Candidiasis, Oral/*DRUG THERAPY/IMMUNOLOGY  Cohort Studies
       Dose-Response Relationship, Drug  Fluconazole/*THERAPEUTIC USE  Human
       Leukocyte Count/DRUG EFFECTS  Prognosis  Prospective Studies  Recurrence
       T4 Lymphocytes/IMMUNOLOGY  MEETING ABSTRACT

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