Oral candidiasis is a common and frequent manifestation of HIV disease. Symptoms of OC include intense burning sensation, pain, alterations or loss of taste, and emotional distress. These symptoms negatively impact upon the desire and ability to eat, nutritional status, and eventually overall health. Exogenous glucose in the oral cavity has been shown to stimulate fungal growth. It is reasoned that reducing exogenous sugars could delay recurrences of OC. A target intervention program """"""""Pro-Self: Candidiasis"""""""" has been designed to provide the knowledge, skills, and encouragement necessary to enable HIV-infected persons to minimize the presence of exogenous sugars in the mouth through changes in diet and oral hygiene methods. A second part of the Pro-Self: Candidiasis program will teach a person how to conduct a competent oral self-exam and to self-diagnose OC in order to foster early detection and treatment.
The specific aims of this study are: 1) to determine, through a controlled, single-blind randomized clinical trial whether the Pro-Self: Candidiasis program of dietary and oral hygiene instruction is effective in increasing inter-episode time for recurrences of OC in susceptible HIV-infected persons; and 2) to determine whether HIV-infected persons in the Pro-Self: Candidiasis study arm self-report the recurrence of their OC more accurately than do HIV-infected persons in the control arm. Participants will be cleared of OC, randomized to the Pro-Self: Candidiasis arm or the Control arm and followed for 26 weeks to determine recurrence frequency. Each recurrence will be treated. Each participant's self-diagnosis will be compared with the investigators' clinical diagnosis to assess accuracy of the participants' diagnoses. If successful, Pro-Self: Candidiasis Program could be widely used by medical and dental health care workers dealing with HIV-infected persons in all risk groups to reduce the morbidity associated with OC by reducing the number of recurrences and reducing the severity of recurrences through earlier detection and prompt treatment. These benefits would substantially increase quality of life for people living with HIV.
| Hilton, Joan F; MacPhail, Laurie A; Pascasio, Laura et al. (2004) Self-care intervention to reduce oral candidiasis recurrences in HIV-seropositive persons: a pilot study. Community Dent Oral Epidemiol 32:190-200 |
