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STUDY TO DETERMINE VARIOUS FUNGI PRESENT IN THE ORAL BUCCAL SMEARS OF HIV POSITIVE PATIENTS

Dr Sara Zubair, Dr Benish Pervaiz, Dr Sana Fatima

Objective: The aim of this study was to observe various fungi in oral smears of HIV / AIDS patients and their relationship to CD4 + lymphocyte count. Study Design: An Observational Study. Place and Duration: In the Department of Oral Pathology, Mayo hospital Lahore for one year duration from March 2018 to March 2019. Methods: Total 35 patients smear who were on antiretroviral therapy (ART) and twenty-five (n = 25) patients without antiretroviral therapy (ART) were included. These smears were routinely stained with H&E, Pap and the specific stains recommended for fungi, namely (PAS) Periodic Acid Schiff and (GMS) Grocott-Gomori Methenamine Silver. By flow cytometry; CD4 + lymphocyte count was determined. Results: In 26% of patients; Candida albicans was found who were taking ART and in patients not taking ART therapy found in 44% of subjects. In 11.4% of subjects with ART, Cryptococcus neoformans was observed and in 4% of cases without ART. In 2.9% patients who were on ART, Coccidioid immitis was noted and in 4% of subjects without ART therapy. In 1.6% of cases who were not taking ART therapy; Aspergillus was observed. The average CD4 + number in which several fungi were observed was less than 300 cells / mm 3 in all categories. The CD4 + lymphocyte count was quantitatively grouped as Group 1 with less than 350 cells / mm3 CD4 + lymphocyte count and Group 2 with above 350 cells / mm3 CD4 + lymphocyte count. The fungi were observed to have a strong association (p = 0.001) in Group 1 with a CD4 + count of less than 350 cells / mm 3, indicating an association with immunosuppression. Conclusion: It may be beneficial to predict the increase in the colonization of Candidal and non-Candidal fungi in the mouth by modest non-invasive approaches such as oral smears, and those subjects should receive prompt medical management to prevent their spread of fungal infections. Keywords: Candida, cytology, non-Candida, HIV / AIDS, CD4 + lymphocyte count, fungi.

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