Work

Antifungal Resistance of Candida spp. Isolates From HIV / AIDS Patients in Iran 1999–2024: A Systematic Review and Meta‐Analysis

Year: 2025

Type: review

Study designs: Systematic Review, 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: = 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. TRIAL REGISTRATION: PROSPERO ID: CRD42024540580.

Source: Journal of Clinical Laboratory Analysis

DOI: 10.1002/jcla.70101