Factors affecting the adherence of Candida albicans to human buccal epithelial cells in human immunodeficiency virus infection.

Adherence to host surfaces is an essential prerequisite for colonization and infection. We compared the adherence of 15 oral isolates of Candida albicans harvested from human immunodeficiency virus (HIV)-infected individuals and 12 isolates from HIV-free individuals to buccal epithelial cells (BECs) from HIV-free individuals, and the adherence of a reference strain of C. albicans to BECs from HIV-infected as well as HIV-free individuals. C. albicans from HIV-infected individuals showed adherence values similar to those from HIV-free individuals. The clinical and laboratory parameters of the subjects from whom the Candida were isolated did not correlate with adherence. A reference strain of C. albicans (GDH 1957), however, adhered more readily to BECs from HIV-infected individuals than to cells from an HIV-free cohort. Several variables were found to be associated with the adherence of C. albicans to BECs from HIV-infected individuals: use of zidovudine, antibacterials and antiparasitics was associated with increased adhesion, while haemophilia, heterosexuality, bisexuality, increased age, decreased CD4 + count and use of folate were associated with a decreased candidal adhesion (all P < 0.05). Our data suggest that the quality of BECs including their receptivity to Candida may play an important part in increasing the oral yeast carriage in HIV infection.