Oral thrush can be a common condition for people with conditions that suppress the immune system, such as HIV. It’s estimated that about
Oral thrush is a yeast infection that causes white or yellowish bumps and patches inside your mouth. It’s most often caused by fungus in the genus Candida.
Candida live in the mouths of most people without causing any symptoms. But for people with compromised immune systems, like those living with HIV, the fungus may spread quicker than the immune system can fight it off.
Keep reading to learn everything you need to know about the connection between oral thrush and HIV.
Oral thrush is medically known as oropharyngeal candidiasis. It’s an overgrowth of yeast in your mouth that leads to yellow or white bumps or patches. These can appear on your inner cheeks, lips, tonsils, or tongue.
Thrush can often cause other symptoms like a sore throat or trouble swallowing.
Oral thrush is typically caused by the fungus Candida albicans, but it can also be caused by other Candida species.
People with suppressed immune systems, such as people living with HIV, people undergoing radiation or chemotherapy, infants, and older adults are most likely to get oral thrush because their immune systems are less able to control the fungus.
Chronic use of
Pictures of oral thrush
People with HIV are prone to oral thrush because the virus weakens the immune system. It’s often among the first symptoms of HIV. It can also be a sign that you’re at risk of developing more severe infections.
Oral thrush is known as an opportunistic infection. The
Stages of HIV
HIV progresses over several stages:
- Acute HIV infection. At
2 to 4 weeksafter contracting HIV, some people develop flu-like symptoms such as a fever, fatigue, and chills. Other people don’t show any symptoms.
- Latency period. After initial exposure, HIV lies dormant for up to 10 to 15 years. During this period, the virus replicates very slowly and may not show any symptoms.
- Stage 3 HIV. If HIV goes untreated, the immune system will eventually weaken. A diagnosis of stage 3 HIV, or AIDS, is indicated when a level of a type of white blood cell called T cells (also called CD4 cells) drops under 200 cells per cubic millimeter of blood, or if an opportunistic infection develops.
As HIV progresses and the immune system becomes more comprised, the risk of developing oral thrush increases.
The standard treatment for oral thrust is antifungal drugs. However, long-term use of these drugs to prevent infection
There hasn’t been a lot of research on how to prevent oral thrush in people at high risk of developing it. But taking good care of your overall mouth health may help. Things you can do include:
- using a soft toothbrush
- cleaning between your teeth, such as with floss
- using mouthwash
- visiting your dentist regularly
- taking good care of dentures if you have them
Drinking plenty of fluids may help prevent oral thrush by helping you avoid mouth dryness.
Other symptoms of oral thrush include:
- mouth soreness or burning
- loss of taste
- dry mouth
- dry and cracked corners of your mouth
- difficulty swallowing or painful swallowing
- bad taste in your mouth
It’s important to seek treatment for oral thrush as soon as you notice it.
The first step to treating oral thrush is to address the underlying cause.
In the case of HIV, antiretroviral therapy suppresses levels of the virus and strengthens the immune system. Antiretroviral therapy is a cocktail of medications used to stop the replication of the virus and prevent the progression of HIV.
For directly targeting oral thrush, the usual treatment is antifungal medication. Oral fluconazole at a dosage of 100 milligrams (mg) once per day is the standard treatment, except in those who are pregnant.
If the infection is in your mouth, you’ll likely undergo treatment for 2 weeks. If it’s in your throat, treatment will likely be 2 to 3 weeks.
If your infection doesn’t respond to fluconazole, your doctor may recommend a different treatment. Other options found to be effective include:
- 50-mg miconazole tablets once per day
- 10-mg clotrimazole lozenges five times per day
- 200 mg of itraconazole oral solution daily
- 400 mg of oral posaconazole suspension twice daily for the first day and then once per day
- 4 to 6 milliliters nystatin suspension four times per day
- topical 0.00165 percent gentian violet twice per day
If you’re having severe or frequent oral thrush reoccurrences, your doctor may recommend a longer course of antifungal medications. However, doctors often try to avoid long-term use when possible since there’s a risk the fungus will become resistant to the medication.
Oral thrush symptoms often show improvement within 2 to 3 days after treated with antifungal medications. The infection usually clears up completely in less than 2 weeks.
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If the antifungal medicine you’re taking to target oral thrush isn’t effective, your doctor may recommend trying a different kind.
Only about 4 to 5 percent of people with HIV don’t respond to antifungal treatment. Most nonresponders have a CD4 count of fewer than 50 cells per cubic millimeter of blood.
If antifungal medications aren’t effective, your doctor may recommend amphotericin B administered through an IV.
For those with HIV not taking antiretroviral therapy, antifungal treatment might cause short-term relief, but the infection will likely come back. As HIV treatment can strengthen the immune system and suppress the virus, it’s the key to avoiding reoccurring or chronic thrush infections.
Oral thrush is a yeast infection that’s most often caused by the fungus Candida albicans. People with HIV or other conditions that suppress the immune system are at a heightened risk of developing oral thrush.
If you have HIV and develop oral thrush, it’s important to see a doctor right away. They’ll likely prescribe an antifungal medication.
Antifungal medication is usually effective for clearing an oral thrush infection. However, you should seek treatment as soon as possible if you notice symptoms.
If you notice symptoms of oral thrush and think you might also have HIV, talk with a doctor or healthcare professional about testing and treatment options.