Prevalence of Candida Species in the Oral Cavity of HIV-Positive Patients at Jos University Teaching Hospital

Oral candidiasis is among the most common opportunistic infections in HIV-positive individuals and serves as a clinical indicator of immune deterioration and treatment adherence, making its characterisation in Nigerian HIV patient cohorts clinically important. This study determines the prevalence and species distribution of Candida in oral cavity samples of HIV-positive patients at Jos University Teaching Hospital (JUTH), Plateau State, North Central Nigeria. Oral swabs were collected from 120 HIV-positive patients attending the antiretroviral therapy clinic. Samples were cultured on CHROM agar Candida for species-specific colour differentiation, and germ tube tests and sugar assimilation profiles confirmed species identification. Antifungal susceptibility was tested against fluconazole, itraconazole, and amphotericin B using the disk diffusion method. Candida carriage was detected in 68 percent of patients. Candida albicans was the predominant species (58 percent), followed by Candida glabrata (19 percent), Candida tropicalis (14 percent), and Candida krusei (9 percent). Fluconazole resistance was identified in 24 percent of all isolates, including all Candida krusei isolates by intrinsic resistance and 17 percent of Candida glabrata. CD4 count below 200 cells/microliter was the strongest predictor of Candida carriage and fluconazole resistance. Recommendations include routine oral Candida screening, species-directed therapy, and CD4-stratified antifungal prophylaxis for JUTH HIV-positive patients. Keywords: oral candidiasis, Candida species, HIV, fluconazole resistance, Jos