Prevalence and Species Distribution of Candida Infection Among HIV Patients in Makurdi, Nigeria

Abstract Background Opportunistic fungal infections remain a major cause of morbidity among people living with HIV (PLHIV), particularly in sub-Saharan Africa. Candida species are the most frequent opportunistic pathogens, yet local epidemiological data in Makurdi, Nigeria, are limited. This study assessed the prevalence and species distribution of Candida infection among HIV patients in Makurdi and explored demographic and treatment-related patterns. Methods A hospital-based cross-sectional study was conducted among 233 HIV-positive patients attending Benue State University Teaching Hospital and General Hospital North Bank. Participants included 218 on antiretroviral therapy (ART) and 15 ART-naïve. Oral and high vaginal swabs were processed using microscopy and culture on Sabouraud Dextrose Agar, followed by species identification. Data were analyzed using descriptive statistics and Chi-square tests. Results Overall prevalence was 49.4% (115/233), with 48.2% among patients on ART and 66.7% among those not on ART, though differences were not statistically significant. Candida albicans was the predominant isolate, but non- albicans species were also detected, particularly in oral samples. Females accounted for 64.3% of positive cases, and the highest prevalence occurred among participants aged 31–40 years. Conclusion Candida infection remains highly prevalent among HIV patients in Makurdi, with notable demographic patterns and predominance of C. albicans . Although ART use was associated with lower prevalence, infection persisted. Findings underscore the need for routine fungal screening, early ART initiation, adherence support, and antifungal resistance surveillance to strengthen HIV care programs in Nigeria.