Insidensi Kandidiasis Oral pada Pasien HIV/AIDS di RSUP Dr. M. Djamil Padang Tahun 2022–2025: Ditinjau dari Durasi Terapi Antiretroviral dan Jumlah CD4

Abstract

Introduction: Oral candidiasis is a frequent opportunistic infection in people living with HIV and is closely associated with cellular immunosuppression, particularly a reduced CD4 count. Although antiretroviral therapy (ART) suppresses HIV replication and supports immune restoration, oral candidiasis may persist when immune recovery is incomplete or when other clinical factors are present. This study aimed to describe oral candidiasis according to CD4 count and ART duration among patients with HIV/AIDS at Dr. M. Djamil General Hospital, Padang. Methods: This retrospective descriptive study reviewed medical records from 2022 to 2025. Records were screened consecutively according to patient registration order. A total of 502 records with complete information on clinically diagnosed oral candidiasis, CD4 count, and cumulative ART duration met the eligibility criteria. The data were analyzed univariately and presented as frequencies and within-category percentages. Results: Oral candidiasis was documented in 35 of 502 patients (7.0%). Within the CD4 categories, the proportions were 13.8% (23/167), 4.9% (8/163), and 2.3% (4/172) among patients with CD4 counts <200, 200-400, and >400 cells/mm³, respectively. According to cumulative ART duration, the proportions were 7.7% (1/13) for <6 months, 10.3% (3/29) for 6-12 months, and 6.7% (31/460) for >12 months. Although the >12-month group contained the largest absolute number of cases, its within-category proportion was not the highest. Discussion: The decreasing proportion across increasing CD4 categories is consistent with the clinical relationship between oral candidiasis and impaired cellular immunity. Conversely, the distribution according to ART duration did not show a monotonic pattern. Because adherence, treatment interruption, ART regimen, viral load, resistance, nutritional status, and mycological confirmation were unavailable, the findings should not be interpreted as evidence of an effect of ART duration. Conclusion: Oral candidiasis was documented in 7.0% of the study population and showed the highest descriptive proportion among patients with CD4 counts <200 cells/mm³. ART duration alone cannot be used as an indicator of immune recovery or oral candidiasis risk.