Genetic variability of Candida albicans in HIV/AIDS patient with and without ARV therapy and non HIV/AIDS

• Main Authors: Retno Puji Rahayu, Widiyanti P, Arfijanto M
• Format: Article
• Language: English
• Published: Universitas Airlangga 2012-03-01
• Series: Dental Journal: Majalah Kedokteran Gigi
• Subjects: Candida albicans; HIV/AIDS; oral candidosis; RAPD; kandidiasis rongga mulut
• Online Access: http://e-journal.unair.ac.id/index.php/MKG/article/view/840

<p><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Background: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Oral candidiasis is the mostly found oral manifestation in HIV/AIDS infected patient caused by immunocompromised </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>especially immunodeficiency. Clinical symptoms is severe pain in oral cavity and dry mouth because of xerostomia which cause the </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>loss of appetite. Candida albicans (C. albicans) is normal flora in oral cavity which plays as opportunistic pathogen and also the cause </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>of oral candidiasis. Almost 90% of HIV–infected patient have oral candidiasis. This condition is clinical problem which has not been </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>well-managed yet. C. albicans colonized oral mucous cavity has different genetic variability for each strain. Phenotype of C. albicans </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>has been determined by genetic factor and environtment. This condition stimulate differences of genotype among various strain of C. </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>albicans in the world. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Purpose: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>The purpose of this research is to analyze the genetic variability of C.albicans which colonized in the </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>mucous oral cavity of HIV/AIDS patient in Surabaya in the treatment with and without ARV therapy and non HIV/AIDS. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Methods: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>This </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>research has been identify and characterize the prevalent strain of C. albicans isolat in Surabaya (East Java) in HIV/AIDS infected </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>patient with oral candidiasis by method of Iatron candidal check. The highlight of this research including cytology examination by </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Papanicoloau staining, C. albicans culture, spheroplast making, DNA isolation and genetic variability checking by randomly amplyfied </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>polymorphism DNA (RAPD). </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Results: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>C. albicans colonizing oral mucosa of non-HIV patients had a predisposition of farther genetic </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>relationship (genetic distance of 0.452) with C. albicans colonizing oral mucosa of HIV ARV and HIV non-ARV patients. The genetic </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>distance was ranging between 0 and 1, where 9 was long genetic distance and 1 was short genetic distance. In contrast, C. albicans </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>colonizing oral mucosa of HIV ARV have predisposition of closer genetic relationship (genetic distance of 0.762) with C. albicans </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>colonizing oral mucosa of HIV non-ARV patients. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Conclusion: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>The conclusion of this research were C.albicans colonizing HIV/AIDS </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>patiens with and without ARV showed no high genetic variability between C.albicans isolate in HIV patients. There fore, the character </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>of C.albicans colonizing HIV ARV and HIV non-ARV patients had similar genotype predisposition of closer relationship value with </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>C.albicans colonizing oral mucosa non HIV patients.</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Latar belakang: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Oral candidiasis merupakan manifestasi kelainan rongga mulut yang paling sering timbul pada penderita HIV/AIDS </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>karena kondisi immunocompromised terutama defisiensi imun. Gejala klinisnya berupa nyeri hebat di rongga mulut dan mulut kering </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>karena xerostomia yang menyebabkan hilangnya nafsu makan. Candida albicans (C. albicans) berperan sebagai patogen oprtunistik </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>dan merupakan penyebab Kandidiasis rongga mulut. Hampir 90% penderita terinfeksi HIV mengalami kandidiasis rongga mulut. </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Kondisi ini merupakan masalah klinis yang belum teratasi dengan baik. Kolonisasi C. albicans di mukosa rongga mulut mempunyai </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>variabilitas genetic yang berbeda untuk tiap strainnya. Fenotip C. albicans ditentukan oleh faktor genetic dan lingkungan. Kondisi ini </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>menstimulir perbedaan genotip di antara berbagai strain C. albicans di dunia. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Tujuan: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Tujuan penelitian ini adalah meneliti korelasi </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>antara hubungan genetik yang menunjukkan variasi genetik kolonisasi C. albicans pada rongga mulut dan insidens kandidiasis rongga </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>mulut pada penderita HIV/AIDS dan non-HIV/AIDS. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Metode: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Penelitian ini mengidentifikasi dan mengkarakterisasi strain Candida </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>albicans isolat Surabaya (Jawa Timur) pada penderita HIV/AIDS dengan kandidiasis rongga mulut dengan metode iatron candidal</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span> <span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>check. Penekanan dalam penelitian ini termasuk pada pemeriksaan sitologi dengan pengecatan Papanicoloau, kultur C. albicans, </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>pembuatan spheroplast, isolasi DNA dan pemeriksaan variabilitas genetik dengan randomly amplified polymorphism DNA (RAPD). </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Hasil: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>C. albicans yang berkolonisasi di rongga mulut pada penderita non-HIV mempunyai predisposisi hubungan genetik (jarak </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>genetik 0.452) dengan C. albicans yang berkolonisasi di rongga mulut pada penderita HIV yang mendapatkan terapi ARV dan non ARV. </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Jarak genetic bervariasi antara 0 dan 1, dimana 9 dalah jarak genetik terpanjang and 1 adalah jarak genetik terpendek. Sebaliknya, </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>C. albicans yang berkolonisasi di rongga mulut pada penderita HIV yang menerima terapi ARV memiliki predisposisi hubungan genetic </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>yang lebih dekat (jarak genetic 0.762) dibandingkan C. albicans yang berkolonisasi di rongga mulut pada penderita HIV non-ARV. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Kesimpulan: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Sebagai kesimpulan, penelitian ini menunjukkan bahwa C. albicans isolate Surabaya yang mengkolonisasi penderita </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>HIV/AIDS dengan ARV dan non ARV memiliki hubungan kekerabatan genetik yang sama dibanding dengan pasien non HIV/AIDS.</em></span></span></span></span></span></span></span></span></span></span></span><br /></em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>