ABSTRACT
BACKGROUND: Controversy surrounds regarding the role of human papillomavirus (HPV) in oral precancerous and cancerous lesions in India where smokeless, tobacco consumption is rampant. AIMS: The present study was carried out with an aim to investigate the presence and type of HPV infection in oropharyngeal leukoplakia and to determine the association of HPV positivity with various patient and lesion characteristics. SETTINGS AND DESIGN: Prospective case series. MATERIALS AND METHODS: A total of fifty confirmed cases of oral leukoplakia (OL), aged 18– 55 years were enrolled in the study. Specimens were obtained from the site of lesion. All the specimens were subjected to histopathological analysis and HPV‑16, 18 detection was done using real‑time polymerase chain reaction technique. RESULTS: Mean age of patients was 34.00 ± 8.85. Majority were males (62%), from middle social class (78%) and were educated up to graduation or above (54%). All the patients had one or more adverse habits (betel, chewing tobacco, smoking and alcohol) with mean duration of disease was 3.53 ± 3.05 years. Five patients (10%) had diabetes. Burning sensation (86%) and trismus (36%) were the reported complaints. Maximum were Stage II (50%), sized 2–4 cm2 (60%), homogenous (70%). Floor of mouth and tongue were most commonly involved sites (50%). Majority had mild dysplasia (58%). Acanthosis (66%), hyperplasia (62%), koliocytosis (40%), and keratosis (98%) were quite common. HPV (16/18) could not be detected in any specimen. CONCLUSIONS: The present study highlighted the fact that association of HPV with oral leukoplakia seems to be overestimated and needs to be reexamined with consensus Human papilloma virus (HPV) primers to detect HPV types with more valid empirical relationships.
ABSTRACT
Background &Objective: Oropharyngeal candidiasis (OPC) is a common feature associated with HIV infection. Over the past decade, reports have documented a shift away from C. albicans as a major cause of infection to non albicans Candida (NAC) species. Several NAC spp are inherently resistant to commonly used antifungal drugs. The objective of the present study was to investigate the distribution pattern of Candida spp. from HIV infected patients with OPC and evaluate its antifungal susceptibility pattern. Methods: A total of 192 HIV infected patients with oropharyngeal lesions (OPL) suggestive of candidiasis and 60 non HIV infected healthy individuals presenting without any OPL were included in the study.Swabs collected from the site of lesions were used for the demonstration and isolation of Candida. Speciation of Candida isolates was done and antifungal susceptibility testing was performed by the disc diffusion method. Results: Out of 192 HIV-infected patients with OPL, 179(93.2%) showed growth of Candida. Isolation of NAC species was higher than C. albicans. Azole resistance was more in NAC species as compared to C. albicans.Conclusions: NAC species has emerged as an important cause of OPC in HIV infected patients. The increased isolation rates of NAC species and a gradual shift in the antifungal susceptibility profile underlines the need of early and accurate diagnosis of infecting Candida spp along with antifungal susceptibility testing for selecting the most appropriate antifungal agent for therapy.