Antifungal resistance of Candida spp. isolates from HIV/AIDS patients in Iran 1999–2024: A systematic review and meta-analysis
Abstract
Background
Antifungal resistance in Candida species in HIV/AIDS patients due to the scarcity of antifungal agents is important particularly in Iran with an estimate of 46,000 individuals living with HIV. This systematic review and meta‐analysis aimed to determine the resistance rate of Candida spp. isolates from HIV/AIDS positive individuals in Iran from 1999 to 2024.
Methods
PubMed, Scopus, Web of Science, MagIran, Scientific Information Database, and Google Scholar were searched and the title‐and‐abstract screening was performed independently by two review authors. The risk of bias assessment and the data extraction were performed independently by two review authors. Meta‐analysis was performed using a random‐effects model with Freeman‐Tukey double arcsine transformation. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses 2020.
Results
From the retrieved 4925 references, 18 references belonging to 15 studies with 1318 Candida spp. isolates were included. The highest pooled resistance rate of Candida spp. was observed against clotrimazole (21%, 95% CI: 14–30, I 2 = 67.29%) while the lowest pooled resistance rates of Candida spp. were observed against voriconazole, caspofungin, amphotericin B, and nystatin with the pooled estimates of 0%. At the species level, the highest pooled resistance rates were observed for Candida krusei against fluconazole (72%, 95% CI: 0%–100%) and itraconazole (38%, 95% CI: 17%–62%), and for Candida glabrata against clotrimazole (38%, 95% CI: 27%–50%).
Conclusions
The use of amphotericin B, caspofungin, and nystatin for the treatment of Candida spp. in HIV‐AIDS patients in Iran is recommended based on clinical indication.
Authors
Fakhri-Demeshghieh A, Yousefipour A, Bolouki Y, Bigdeli MS, Zamani E, Farajkhoda A, Salmani A, Katiraee F, Bokaie S
Year
2025
Topics
- Population(s)
- General HIV+ population
- Co-infections
- Other
