Living with HIV can increase a person’s chances of developing candidiasis, which is an infection that occurs due to an overgrowth of the Candida fungus.
The Candida fungus typically lives on the body without causing any problems. However, if it grows out of control, it can lead to candidiasis.
Although anyone can develop candidiasis, people living with HIV have a higher chance of developing this type of infection.
This article reviews the connection between candidiasis and HIV. It also looks at how to treat candidiasis infections that develop on the penis and in the vagina, mouth, throat, and esophagus.
Candidiasis is an opportunistic fungal infection. When allowed to thrive, the fungus will grow out of control.
It reports that candidiasis affecting the mucous membranes of the body is a
- penile or vaginal candidiasis
- oral candidiasis, which affects the mouth
- esophageal candidiasis, which affects the esophagus
- oropharyngeal candidiasis, which affects the mouth and throat
It is important to remember that vulvovaginal candidiasis can develop in healthy individuals without any underlying condition.
Also, esophageal and oropharyngeal candidiasis can develop in people with untreated or uncontrolled HIV levels when levels of CD4 drop. CD4 cells are a type of white blood cell that helps fight infection.
According to a 2018 study, oropharyngeal candidiasis can indicate the presence of undiagnosed HIV or the progression of HIV.
The study also noted that this type of infection could occur months to years before more severe opportunistic infections associated with HIV appear.
There are several different types of candidiasis.
Oral, oropharyngeal, and esophageal
Esophageal candidiasis is a fungal infection in the tube that connects the throat to the stomach. It is one of the most common infections to affect people living with HIV. However, highly active antiretroviral therapy
According to NAM, a British charity organization, oral candidiasis is most likely to occur when a person has a low CD4 count.
The United States Department of Veterans Affairs notes that healthcare professionals use a CD4 count to help them identify how well the immune system is functioning in those with HIV.
Symptoms of candidiasis affecting the mouth and throat include:
- white patches or plaques a person can wipe off, resulting in red areas that may bleed
- redness in the mouth and throat
- an unpleasant taste in the mouth or a loss of taste
- cracks in the corners of the mouth
- a burning or painful feeling in the mouth
- pain when eating or drinking
The white plaques can develop in the following places:
- inner cheeks
- roof of the mouth
A person may also experience pain and difficulty when swallowing if they have developed esophageal candidiasis.
Vaginal and penile
HIV can increase the chance of developing vaginal or penile candidiasis.
Symptoms of vaginal candidiasis include:
- vaginal soreness and itching
- unusual discharge that can be thick and yellow-white in color or clear and watery
- pain during sex
- pain and discomfort when urinating
Although candidiasis on the penis may not present with symptoms, a person may experience:
- irritating, itching, or burning under the foreskin or at the tip of the penis
- discharge under the foreskin that is white or curd-like in appearance
- an unpleasant smell in some cases
These symptoms can often occur in healthy individuals. They are not necessarily an indicator of an HIV infection.
To treat candidiasis, a person can take antifungal drugs. This can include a fluconazole tablet.
There is an evolving resistance of Candida species to fluconazole as a result of repeated or prolonged exposure. There are also Candida species that have an inherent resistance to this class of drugs.
In these cases, a healthcare professional can prescribe other antifungal medications.
The CDC recommends topical clotrimazole, miconazole, or nystatin for
For vaginal candidiasis, a person can use antifungal medications in the form of a pessary or topical ointment. Topical ointments can also treat penile candidiasis.
For more severe cases of candidiasis, a healthcare professional may provide antifungal medications intravenously or in the form of a tablet.
When diagnosing candidiasis, a doctor
- review a person’s medical history
- perform a physical examination
- review symptoms
- order blood tests or take a sample from the affected area
In some cases, a doctor may be able to make a diagnosis through observation of the involved area alone. They may also start treatment with antifungal medication to help confirm the diagnosis in certain cases.
HIV.gov notes that Candida albicans is the most common type of yeast that causes candidiasis. It is also naturally present on several surfaces of the human body, which means preventing exposure to the fungus is impossible.
Although regular use of fluconazole can help prevent candidiasis, healthcare professionals do not recommend it. This is due to the success of acute therapy, the low risk associated with the infection, and the possibility of drug-resistant candidiasis.
The recommended form of prevention is to restore immune function through treatments such as antiretroviral therapy. People may also benefit from good oral hygiene to help prevent oral candidiasis.
To help prevent vaginal or penile candidiasis, a person can:
- wear cotton underwear and loose-fitting clothing
- wash the penis or vagina using water and an emollient cream instead of soap
- dry the area well after washing
People should avoid:
- vaginal deodorants
- perfumed shower gels and soaps
In most cases, candidiasis is easy to treat and responds to antifungal medications, such as fluconazole. The infection is generally not life threatening and unlikely to lead to comorbidities.
A person living with HIV should contact a doctor if they experience symptoms.
A person should speak with a doctor if they experience any symptoms related to candidiasis in their mouth or throat. These may indicate an underlying health condition affecting their ability to fight off infection.
A person with HIV should also speak with a doctor if they develop candidiasis in the mouth or throat, as it could indicate HIV is progressing or getting worse.
Vaginal or penile candidiasis may not indicate any underlying health concerns. However, a person should still seek medical advice, especially if symptoms do not resolve with over-the-counter (OTC) treatment.
While a person can treat the symptoms with OTC medications, a doctor should confirm the infection. Continuing symptoms
Candidiasis is a fungal infection that can occur anywhere but often appears on the penis and in the vagina, mouth, throat, and esophagus.
In most cases, the infection occurs due to an overgrowth of fungus that naturally lives on or in the human body. In people living with HIV, the overgrowth can occur due to a weakened immune response, which could indicate the presence or progression of HIV.
A person can take antifungal medications to treat candidiasis. To help prevent future infections and maintain the function of their immune system, people should continue to take their HIV medication.