Increased prevalence of oral Candida albicans serotype B in homosexual men: a comparative and longitudinal study in HIV-infected and HIV-negative patients

Several investigators have shown a comparatively high prevalence of Candida albicans serotype B among HIV-infected individuals. We serotyped oral C. albicans strains from 50 HIV-infected homosexual men, 39 HIV-seronegative homosexual men and 40 clinical oral isolates of a control group. The prevalence of serotype B was significantly higher in homosexual men, regardless of HIV serostatus, than in the control subjects. We suggest that the reported high prevalence of serotype B among AIDS patients in Europe and the USA simply reflects the high proportion of homosexual men among HIV-infected patients. In 22 subjects, oral C. albicans isolates were obtained at two or more time points, up to 8 years apart. No change in serotype was observed over time. The serotype prevalences in HIV-infected patients with oral thrush or AIDS-defining illness were similar to the group of homosexual men as a whole, indicating that there is no serotype-related variation in pathogenicity.