Evolution of vaginal Candida species recovered from human immunodeficiency virus-infected women receiving fluconazole prophylaxis

The emergence of Candida glabrata?

Jose Antonio Vazquez, Jack D. Sobel, Grace Peng, Lynn Steele-Moore, Paula Schuman, William Holloway, James D. Neaton

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

The effect of fluconazole prophylaxis on the vaginal flora of 323 human immunodeficiency virus-infected women was evaluated in a multicenter, randomized, double-blind, placebo-controlled trial. Women with CD4 cell counts of ≤300/mm3 received either 200 mg of fluconazole per week or placebo. Vaginal surveillance cultures were performed every 3 months. After a follow-up of 29 months, Candida albicans was recovered from 53% of patients receiving fluconazole and 68% of patients assigned placebo. Fluconazole was associated with a 50% reduction in the odds of being colonized with C. albicans but with higher rates for non-albicans Candida species. Candida glabrata was recovered from 40 women assigned fluconazole and 29 assigned placebo (relative odds, 1.96; 95% confidence interval, 0.98-3.94). Fluconazole had an early and persistent effect on the vaginal mycoflora, with the emergence of C. glabrata vaginal colonization within the first 6 months. The effect of fluconazole prophylaxis can be attributed to the reduction in vaginal C. albicans colonization; however, C. glabrata colonization rapidly supervened.

Original languageEnglish (US)
Pages (from-to)1025-1031
Number of pages7
JournalClinical Infectious Diseases
Volume28
Issue number5
DOIs
StatePublished - Jan 1 1999

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Candida glabrata
Fluconazole
Candida
HIV
Candida albicans
Placebos
CD4 Lymphocyte Count
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Evolution of vaginal Candida species recovered from human immunodeficiency virus-infected women receiving fluconazole prophylaxis : The emergence of Candida glabrata? / Vazquez, Jose Antonio; Sobel, Jack D.; Peng, Grace; Steele-Moore, Lynn; Schuman, Paula; Holloway, William; Neaton, James D.

In: Clinical Infectious Diseases, Vol. 28, No. 5, 01.01.1999, p. 1025-1031.

Research output: Contribution to journalArticle

Vazquez, Jose Antonio ; Sobel, Jack D. ; Peng, Grace ; Steele-Moore, Lynn ; Schuman, Paula ; Holloway, William ; Neaton, James D. / Evolution of vaginal Candida species recovered from human immunodeficiency virus-infected women receiving fluconazole prophylaxis : The emergence of Candida glabrata?. In: Clinical Infectious Diseases. 1999 ; Vol. 28, No. 5. pp. 1025-1031.
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