Relationship of oral candidiasis with salivary lysozyme and lactoferrin in HIV-positive patients: a systematic review

Oral candidiasis is one of the main consequences of human immunodeficiency virus (HIV) infection. Saliva contains proteins that play a key role in the health of oral cavity. The aim of this review study was to investigate the relationship of oral candidiasis with salivary lysozyme and lactoferrin in patients with HIV infection. In this systematic review study, all articles with English abstract were searched with the keywords of "Oral Candidiasis" or "Candida" and "Saliva" and "HIV" or "AIDS" and "Lysozyme" and "Lactoferrin" from the Google Scholar, PubMed, Web of Science, Cochrane, and Scopus databases from 1990 until April 2020. Amongst the 16 articles obtained after reviewing the abstracts, 13 appropriate articles were included in this study. In 11 studies, the relationship between salivary lactoferrin and oral candidiasis was investigated, 54% of which showed an increase in salivary lactoferrin in HIV-positive patients with candidiasis. Eight studies examined the relationship between salivary lysozyme and oral candidiasis, 63% of which showed no association. Understanding numerous factors and conditions involved in candida cloning would be broadly related to increasing our understanding of fungal pathogenesis and host defense factors. The results of our study could be useful in diagnosing and designing new strategies for the prevention and treatment of fungal infections in HIV-positive patients. In addition to anti-fungal properties, non-toxicity to human cells could lead to lactoferrin being used in the future as a drug to prevent and treat fungal infections in patients with immunity difficulties.