Hindawi Publishing Corporation AIDS Research and Treatment Volume 2012, Article ID 262471, 5 pages doi:10.1155/2012/262471 Research Article The Changing Epidemiology of Oropharyngeal Candidiasis in Patients with HIV/AIDS in the Era of Antiretroviral Therapy Payal K. Patel, 1, 2, 3 Joshua E. Erlandsen, 3 William R. Kirkpatrick, 2, 3 Deborah K. Berg, 2, 3 Steven D. Westbrook, 2, 4 Christopher Louden, 5 John E. Cornell, 5 George R. Thompson, 6 Ana C. Vallor, 7 Brian L. Wickes, 8 Nathan P. Wiederhold, 3 Spencer W. Redding, 2, 4 and Thomas F. Patterson 2, 3 1 Department of Internal Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA 2 South Texas Veterans Health Care System, San Antonio, TX 78229, USA 3 Division of Infectious Diseases, The University of Texas Health Science Center at San Antonio, Department of Medicine, 7703 Floyd Curl Drive, MSC 7881, San Antonio, TX 78229-3900, USA 4 Department of Comprehensive Dentistry, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA 5 Department of Epidemiology & Biostatistics, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA 6 Department of Internal Medicine, University of California at Davis School of Medicine, Davis, CA 95817, USA 7 University of Incarnate Word, San Antonio, TX 78209, USA 8 Department of Microbiology and Immunology, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA Correspondence should be addressed to Payal K. Patel, patelp6@uthscsa.edu Received 25 April 2012; Accepted 14 July 2012 Academic Editor: Robert S. Hogg Copyright © 2012 Payal K. Patel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The impact of antiretroviral therapy (ART) on opportunistic conditions in HIV patients continues to evolve. We specifically studied the changing epidemiology of oropharyngeal candidiasis (OPC) in 215 HIV/AIDS patients. Status of yeast colonization was assessed from oral rinse samples, and preliminary yeast identification was made using CHROMagar Candida and confirmed with standard microbiological techniques and/or molecular sequencing. Susceptibility to fluconazole was determined by CHROMagar Candida agar dilution screening and CLSI broth microdilution. 176 (82%) patients were colonized and 59 (27%) patients had symptomatic OPC. Candida albicans was the most prevalent species, though C. glabrata and C. dubliniensis were detected in 29% of isolates. Decreased fluconazole susceptibility occurred in 10% of isolates. Previous ART reduced the risk of OPC, while smoking increased the risk of colonization. Oral yeast colonization and symptomatic infection remain common even with advances in HIV therapy. C. albicans is the most common species, but other yeasts are prevalent and may have decreased susceptibility to fluconazole. 1. Introduction Candida albicans is a frequent component of oral ecology found in up to 75% of humans [1]. In immunocompromised patients, Candida species can cause a multitude of disease manifestations ranging from mild oral disease to dissemi- nated candidiasis. Diagnosis and treatment of disease caused by Candida species is especially important in HIV/AIDS patients who, despite the advent of antiretroviral therapy (ART), continue to suffer significant Candida associated morbidity [2, 3]. Of particular concern is oropharyngeal candidiasis (OPC), an opportunistic yeast infection of the soft and hard palates, pharynx, tongue, and buccal mucosa. OPC can