Paracoccidioidomycosis in Patients Infected with and Not Infected with Human Immunodeficiency Virus: A Case-Control Study

• Published in: The American journal of tropical medicine and hygiene Vol. 80; no. 3; pp. 359 - 366
• Main Authors: Morejon, Karen M. Loro, Machado, Alcyone Artioli, Martinez, Roberto
• Format: Journal Article
• Language: English
• Published: Deerfield, IL ASTMH 01-03-2009; American Society of Tropical Medecine and Hygiene
• Subjects: Adolescent; Adult; Aged; Anti-HIV Agents - administration & dosage; Anti-HIV Agents - therapeutic use; Antifungal Agents - therapeutic use; Antiretroviral Therapy, Highly Active; Biological and medical sciences; Blastomycoses and paracoccidioidomycosis; Brazil - epidemiology; Case-Control Studies; Female; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; Human immunodeficiency virus; Human mycoses; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Male; Medical sciences; Middle Aged; Mycoses; Paracoccidioides brasiliensis; Paracoccidioidomycosis - complications; Paracoccidioidomycosis - drug therapy; Paracoccidioidomycosis - epidemiology; Prevalence; Retrospective Studies; Tropical mycoses; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; Brazil; Human; Immunopathology; Blastomycosis; Mycosis; Retroviridae; AIDS; Case control study; Immune deficiency; Lentivirus; Infection; Virus; Viral disease; Tropical medicine; Paracoccidioidomycosis; Human immunodeficiency virus
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/ajtmh.2009.80.359

Epidemiologic and clinical data for 53 patients with paracoccidioidomycosis and co-infected with human immunodeficiency virus (HIV) (cases) were compared with those for 106 patients with endemic paracoccidioidomycosis (controls). The prevalence of Paracoccidioides brasiliensis co-infection was estimated in 1.4% in cases of acquired immunodeficiency syndrome (AIDS). Patients co-infected with HIV were younger, less involved in agricultural occupations; 83.7% had CD4+ cell count < 200 cells/microL. Paracoccidioidomycosis in co-infected patients usually showed a rapid progression, with more fever, frequent involvement of the lungs, and multiple extrapulmonary lesions. The response to antifungal therapy and deaths caused by paracoccidioidomycosis were similar in the two patient groups, but late relapses were more common in co-infected cases. Paracoccidioidomycosis in HIV-infected patients shows epidemiologic and clinical characteristics differing from those of the endemic disease and should be considered an AIDS-defining opportunistic infection in Latin America.