Candida albicans allergen immunotherapy in recurrent vaginal candidiasis
Moraes, P.S.; de Lima Goiaba, S.; Taketomi, E.A.
Journal of Investigational Allergology and Clinical Immunology 10(5): 305-309
2000
ISSN/ISBN: 1018-9068 PMID: 11108444 Document Number: 521165
The efficacy of C. albicans allergen immunotherapy was evaluated in women with immediate skin test positivity for this fungus. A prospective cohort study was conducted in Brazil of women with recurrent vaginal candidosis referred by gynaecologists to an allergist. All patients had established positive C. albicans in vaginal cultures and were unresponsive to other modes of treatment. None had diabetes or AIDS. In their allergy evaluation, they had immediate (prick or intradermal) skin test positivity to C. albicans. These women were offered the option of C. albicans allergen immunotherapy for a period of 24 months. The efficacy of therapy was evaluated by comparison of the mean incidence of episodes per year before and after immunotherapy. Over a period of 33 months, 34 women were enrolled (mean age 33.5 years; range 18-57). They were treated with weekly injections of C. albicans allergenic extract over a mean period of 17.4+or-7.2 months (4-24 months). 22 of the women had improvement in symptoms. There were complete responses (absence of acute episodes for 2 years) in 9 patients (26%) and partial responses (decrease in the number and intensity of episodes) in 13 patients (38%). Overall there was a 64% improvement in these patients (95% CI: 46.5-79.9). 11 patients showed no improvement and one worsened. The effects were evident after 2-12 months of therapy (mean 3.5 months). The mean incidence of episodes of vaginitis per year decreased from a mean of 8.5+or-2.6 to 3.6+or-4.3 (P=0). The study also showed that the majority of patients were atopic (70%), had allergic rhinitis (67%) and familial history of allergy (70%). It is suggested that in a subgroup of patients with recurrent vaginal candidosis, C. albicans allergen immunotherapy lowers the number and intensity of episodes.