A randomized clinical trial of chlorhexidine in the maintenance of oral candidiasis-free period in HIV infection

Objective: To determine if chlorhexidine can be used as an intervention to prolong the time to relapse of oral candidiasis. Subjects and methods: A double‐blinded randomized clinical trial was performed in 75 HIV/AIDS subjects with oral candidiasis. Clotrimazole troche was prescribed, and the subjects were re‐examined every 2 weeks until the lesions were completely eradicated. The subjects were then randomly divided into two groups; 0.12% chlorhexidine (n = 37, aged 22–52 years, mean 34 years) and 0.9% normal saline (n = 38, aged 22–55 years, mean 38 years). They were re‐examined every 2 weeks until the next episode was observed. Results: The time to recurrence of oral candidiasis between the chlorhexidine and the saline group was not statistically significant (P > 0.05). The following variables were significantly associated with the time of recurrence; frequency of antifungal therapy (P = 0.011), total lymphocyte (P = 0.017), alcohol consumption (P = 0.043), and candidiasis on gingiva (P = 0.048). The subjects with lower lymphocyte showed shorter oral candidiasis‐free periods (P = 0.034). Conclusions: Chlorhexidine showed a small but not statistically significant effect in maintenance of oral candidiasis‐free period. This lack of significance may be due to the small sample size. Further study should be performed to better assess the size of the effect, or to confirm our findings.