Correlation of subclinical candidal colonization of the dorsal tongue surface with the Walter Reed staging scheme for patients infected with HIV-1

The correlation between subclinical candidal colonization of the dorsal tongue surface and the Walter Reed staging scheme for patients positive for human immunodeficiency virus (HIV-1) antibody is reported. Of 76 cytologic smears of the dorsal tongue surface, 12 (16.2%) demonstrated subclinical colonization. The mean peripheral helper T-lymphocyte count for patients with subclinical colonization was 304 ± 226 cells/mm³ and was not significantly different from seropositive patients without colonization (411 ± 209 cells/mm³). The Walter Reed scheme for assessing progressive immunodysregulation did not significantly correlate with the presence of subclinical colonization. This study suggests a more complex pathogenesis for oral candidiasis in HIV-1-infected patients rather than a direct link to peripheral helper T-lymphocyte depletion below a count of 400 cells/mm³.