Oral candidiasis is one of the opportunistic infections commonly associated with AIDS. The overall objective of this work is to understand the relationship between the development of oral candidiasis and pathogenesis of AIDS. The initial study examined by culture the level of oral yeast in a population of HIV-I antibody positive AIDS patients with no history of opportunistic infections. Both the patient group and the normal control group consisted of non-smoking, non-denture-wearing males taking no medication. The mean level of yeast in the whole saliva of the AIDS patients was 13,000 colony-forming-units (cfu) per milliliter compared to a mean of less than 1.0 cf/ml in the control group. Identification of the yeasts showed that Candida albicans was the predominant yeast in both groups. These results indicate that 1) high oral yeast concentration in whole saliva may be an early sequela of HIV-I infection, 2) high levels of oral yeast precede overt clinical signs of candidiasis, and 3) the oral yeast in these patients results from proliferation of the normal yeast oral flora rather than colonization by unusual species.
