Oral candidal carriage, salivary lysozyme levels, and their relationship with CD4 count in HIV-infected patients

Aim: The aim of the present study was to compare the lysozyme concentration and candidal count in saliva between HIV-seropositive and HIV-negative individuals, and to correlate the relationship between lysozyme concentrations, candidal count, and CD4 count in HIV patients. Methods: A study was conducted in 90 HIV-seropositive patients (subgroups: 1 [CD4 >= 500 cells/mu L], 2 [CD4 200-499 cells/mu L], and 3 [CD4 = 200 cells/mu L] and 30 HIV-negative individuals. A total of 6 mL unstimulated saliva was collected and stored at -80 degrees C. Samples were centrifuged and divided into two portddions of 600 mu L each. One portion was used for the candidal assay and the other for the lysozyme assay using readymade kits. Student's independent t-test and Karl Pearson correlation coefficient were used for the statistical analysis. Results: There was a significant increase (P < 0.001) in lysozyme levels and the candidal count in the saliva of HIV-positive individuals compared with the HIV-negative individuals. A significant increase (P < 0.004) in the salivary candidal count was observed in the HIV subgroups 1-3. There was a significant negative correlation (P < 0.01) between the CD4 and candidal counts in subgroup 1 (P < 0.02) and between the lysozyme concentration and CD4 count in subgroup 3. There was no correlation between the lysozyme concentration and oral candidal carriage. Conclusions: An association exists between the lysozyme concentration and specific immunity. Yeast colonization serves as a marker of immunodeficiency in HIV disease progression.