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TOLL-FREE HIV HEALTH INFOLINE 1-800-822-7422 LOCAL &
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Oral candidiasis and HIV disease
EMAIL YOUR QUESTIONS TOwww.projectinorm.org/questions2
Systemic treatments that work
throughout the body are used or
recurring disease or outbreaks that
do not clear up with topical treat-
ment and or esophageal candidiasis.
Fluconazole (Diucan) tablets are as
eective as lozenges, and are generally
easier to take and tolerate.ree antiungal drugs are used to
treating oral and esophageal can-
didiasis. ey include Nizoral (keto-
conazole, taken with acidic ood or
drink), Sporanox (itraconazole, great
potential to interact with HIV drugs)
or Diucan (uconazole, which tends
to be saved or later use).
Side efects anddrug interactions
Common side eects o oral azole
drugs (ketoconazole, uconazole and
itraconazole) are nausea, vomiting
and belly pain. Others include head-
aches, dizziness, drowsiness, ever, di-
arrhea, rash and changes in the sense
o taste. e most serious problem is
liver toxicity, but this is rare and usu-
ally reverses aer treatment when the
drug is stopped. Nevertheless, liverunction should be checked
closely,
particularly with ketoconazole.
Intravenous amphotericin B may
pose serious side eects, including
kidney toxicity. e most common
side eects are ever, shaking, chills,
altered blood pressure, nausea, vomit-
ing and headache. ese reactions are
usually severe aer the frst ew doses
and lessen with subsequent treatment.
Liposomal versions o the drug (like
Abelcet) are generally less toxic and as
eective than its earlier ormula. Intra-
venous AmB should only be used in
cases where there is a direct threat to lie
or all other treatments have ailed.Many drug interactions are
possible
when taking azole drugs and AmB.
Some can cause several heart or kidney
problems. Be clear about all the medi-
cines you take and consult a pharmacist
about possible interactions.
Prevention
Using antiungal drugs to prevent
ungal inections is approached with
great care and is generally discour-
aged, especially using uconazole this
way. is makes treating newer and
more aggressive inections more di-
fcult and oen unsuccessul. How-ever, this may not be possible in
some
people with recurrent inections who
must remain on long-term therapy to
prevent them.
Antiungal drugs and pregnancy
e Federal Guidelines for the Prevention ofOpportunistic
Infections recommend not using
antiungal drugs during pregnancy due to pos-
sible birth deects. ey urther state that azoles
be stopped in women who become pregnant
and that women taking these drugs use eective
birth control.
Topical therapies may be preerable or preg-
nant women. For systemic treatment the Guide-
lines suggest using AmB, especially in the frst
trimester.
Although no ormal studies have been done,
pregnant women have used amphotericin B
without apparent harm to their unborn children,
though the drug has possible severe side eects
including kidney toxicity and anemia.
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Oral candidiasis and HIV disease
EMAIL YOUR QUESTIONS TOwww.projectinorm.org/questions 3
Tips or preventing ungal inections
Some nutritionists believe garlic
has natural antiungal properties.
Fresh garlic is considered best,
although commercial garlic pills
help reduce the odors. NOTE:
Large amounts o garlic may in-terere with HIV meds,
especially
Norvir (ritonavir).
Antibiotics may lead to yeast in-
ections. Friendly bacteria are
ound naturally in the body and
help clear unriendly yeasts. Com-
mon antibiotics kill these bacteria
which then allow yeast to grow,
especially in the vagina.
Other publicationsthat may help
Oral Health and HIV Disease
www.projectinform.org/oral/
Systemic Candidiasis
www.projectinform.org/candida_s/
Vaginal Candidiasiswww.projectinform.org/candida_v/
PROJECT INFORM 1375 MISSION STREET SAN FRANCISCO, CA 94103-2621
415-558-8669 WWW.PROJECTINFORM.ORG
FACING NEW DECISIONS? WONDERING WHATS THE NEXT STEP?
HIV Health Inoline: 1-800-822-7422 (toll-ree)10a4p,
MondayFriday, Pacifc Time
Overall, the best way to naturally
prevent ungal inections is to eat
healthully and regularly, avoid
excessive sugar intake, and avoidor decrease alcohol, caeine,
dairy
and cigarettes.
Decrease or avoid sugars (corn
and maple syrup, glucose, ruc-
tose and sucrose). Sugar is ood
or Candida and helps it grow.
Read the labels on packaged oods
or these sugars.
Decrease or avoid alcohol. Alco-
hol converts to sugar and helps
Candida grow.
Drink milk or eat yogurt that
contains acidophilus bacteria
riendly bacteria that helps your
body fght o unriendly germs,
like Candida. Also available in
health ood stores.
Eat larger amounts o ood that
may keep yeast rom growing.
