TITLE

Changing Epidemiology of Invasive Fungal Infections: Focus on HIV/AIDS Patients

AUTHOR(S)
Antinori, Spinello
PUB. DATE
March 2010
SOURCE
Journal of Invasive Fungal Infections;2010, Vol. 3 Issue 4, p105
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The epidemiology of invasive fungal infections (IFI) in HIV/AIDS patients has changed profoundly since the introduction of highly active antiretroviral therapy (HAART) at the end of 1996. Early initiation of HAART with reversal of severe immunodeficiency is the main factor responsible for the decreasing incidence and prevalence of pneumocystosis, extrapulmonary cryptococcosis, progressive disseminated histoplasmosis, coccidioidomycosis, and penicilliosis marneffei in AIDS patients. Nonetheless, in Western countries, these opportunistic mycoses still occur in patients who are unaware of their HIV status and in those failing to respond adequately to HAART. In resource-poor countries, IFI such as cryptococcosis are still responsible for a huge disease burden. Globalization and immigration account for the observation of such geographical mycoses (e.g. histoplasmosis, coccidinidomycosis, and penicilliosis marneffei) outside endemic regions, posing a challenge to the inexperienced physician. In addition, the immune recovery induced by HAART might be responsible for the immune reconstitution inflammatory syndrome that has been described particularly with cryptococcal meningitis presenting with symptoms that mimic a relapse. In patients experiencing a good immunological response to HAART, primary or secondary prophylaxis for pneumocystosis, cryptococcosis, histoplasmosis, or penicilliosis can be safely discontinued.
ACCESSION #
52519759

 

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