Oral candidiasis (thrush) associated with human immunodeficiency virus (HIV) infection occurs commonly and recurs frequently, often presenting as an initial manifestation of the disease. Interventions aimed at preventing and treating HIV-associated oral thrush form an integral component of maintaining the quality of life for affected individuals. This review evaluated the effects of interventions in preventing or treating oral thrush in children and adults with HIV infection. Thirty three trials (n=3445) were included. Twenty two trials investigated treatment and eleven trials investigate prevention. There was no difference with regard to clinical cure between fluconazole compared to ketoconazole, itraconazole, clotrimazole and posaconazole. Fluconazole, gentian violet and ketoconazole were superior to nystatin. Compared to placebo and no treatment, fluconazole was effective in preventing clinical episodes from occurring. Continuous fluconazole was better than intermittent treatment. Insufficient evidence was found to come to any conclusion about the effectiveness of clotrimazole, nystatin, amphotericin B, itraconazole, ketoconazole or chlorhexidine with regard to OC prophylaxis.
Pienaar, E.D.; Young, T.; Holmes, H. Interventions for the prevention and management of oropharyngeal candidiasis associated with HIV infection in adults and children. Cochrane Database of Systematic Reviews (2006) (Issue 11) Art. No.: CD003940. [DOI: 10.1002/14651858.CD003940.pub3]