Fungal Opportunistic Infections in HIV Disease

2006 ◽  
Vol 19 (1) ◽  
pp. 17-30 ◽  
Author(s):  
Melody L. Duffalo
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Fungal Pathogens ◽  
Histoplasma Capsulatum ◽  
Opportunistic Infections ◽  
Fungal Infections ◽  
Hiv Disease ◽  
Highly Active ◽  
Immunocompromised Individual ◽  
Fungal Organisms ◽  
Advanced Hiv Disease

Fungal pathogens can lead to many of the complications seen in advanced HIV disease and are commonly identified in HIV-infected populations with decreased immune function. Common fungal organisms affecting individuals with AIDS include Cryptococcus neoformans, various Candida species, and Histoplasma capsulatum. While infection with these organisms can be fatal, appropriate identification and management of the condition can result in reduced mortality and the opportunity for effectivemanagement of HIV disease with highly active antiretroviral therapy. This article describes the clinical presentation and treatment of 3 fungal infections common in the immunocompromised individual with AIDS. Current antifungal therapy for themanagement of these infections is discussed. In addition, the role of newer antifungal agents in the setting of these conditions is reviewed.

Africans in London continue to present with advanced HIV disease in the era of highly active antiretroviral therapy

AIDS ◽  
2001 ◽  
Vol 15 (18) ◽  
pp. 2453-2455 ◽  
Author(s):  
Fiona M. Burns ◽  
Ade O. Fakoya ◽  
Andrew J. Copas ◽  
Patrick D. French
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Hiv Disease ◽  
Highly Active ◽  
Advanced Hiv Disease

Highly Active Antiretroviral Therapy Decreases Mortality and Morbidity in Patients with Advanced HIV Disease

2001 ◽  
Vol 135 (1) ◽  
pp. 17 ◽  
Author(s):  
Edward L. Murphy ◽  
Ann C. Collier ◽  
Leslie A. Kalish ◽  
Susan F. Assmann ◽  
Michael F. Para ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Hiv Disease ◽  
Mortality And Morbidity ◽  
Highly Active ◽  
Advanced Hiv Disease

scholarly journals Opportunistic fungal infections in persons living with advanced HIV disease in Lagos, Nigeria; a 12-year retrospective study

2020 ◽  
Vol 20 (4) ◽  
pp. 1573-81
Author(s):  
Rita Oladele ◽  
Folasade Ogunsola ◽  
Alani Akanmu ◽  
Katie Stocking ◽  
David W Denning ◽  
...  
Keyword(s):  
Opportunistic Infections ◽  
Fungal Infections ◽  
Oral Candidiasis ◽  
Pneumocystis Pneumonia ◽  
Cd4 Count ◽  
University Teaching ◽  
Base Line ◽  
Hiv Disease ◽  
Advanced Hiv Disease ◽  
Oesophageal Candidiasis

Introduction: Nigeria has a large estimated burden of AIDS-related mycoses. We aimed to determine the proportion of pa- tients with AIDS-related opportunistic fungal infections (OFIs) at an urban antiretroviral treatment (ART) centre in Nigeria. Methods: A retrospective analysis of a cohort of ART-naïve, HIV-infected patients, assessed for ART eligibility and ART- experience at the PEPFAR outpatient clinic at Lagos University Teaching Hospital over a 12-year period (April 2004-Feb- ruary 2016) was conducted. Results: During this period, 7,034 patients visited the clinic: 4,797 (68.2%) were female; 6161 patients had a recorded base- line CD4 count, and the median CD4 count was 184 cells/µl (IQR, 84-328). A baseline HIV-1 viral load (VL) was recorded for 5,908 patients; the median VL was 51,194 RNA copies/ml (IQR, 2,316-283,508) and 6,179/7046(88%) had initiated ART. Some 2,456 (34.9%) had a documented opportunistic infections, of whom 1,306 (18.6%) had an opportunistic fungal infection. The total number of OFI episodes was 1,632: oral candidiasis (n=1,473, 90.3%), oesophageal candidiasis (n=118; 8%), superficial mycoses (n=23; 1.6%), Pneumocystis pneumonia (PJP) (n=13; 0.8%), and cryptococcal meningitis(CM) (n=5; 0.4%). 113 (1.6%) were known to have died in the cohort. Conclusion: Approximately 1 in 5 HIV-infected patients in this retrospective cohort, most of whom had initiated ART, were clinically diagnosed with an OFI. Improved access to simple accurate diagnostic tests for CM and PJP should be pri- oritised for this setting. Keywords: Opportunistic fungal infections; ART Adherence; Advanced HIV disease.

Multiple opportunistic AIDS-associated disorders strictly related to immunodeficiency levels, in a girl with congenital HIV infection

2003 ◽  
Vol 14 (9) ◽  
pp. 638-639 ◽  
Author(s):  
Roberto Manfredi ◽  
Leonardo Calza ◽  
Francesco Chiodo
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Virologic Failure ◽  
Hiv Disease ◽  
Genotypic Resistance ◽  
Highly Active

A 16-year-old girl with vertical HIV disease treated since birth suffered from six different AIDS-defining disorders until now. Even during the highly active antiretroviral therapy, multiple AIDS-related opportunistic infections may complicate the course of long-term congenital HIV disease, showing a strict relationship with immunological deterioration, which occurs shortly after virologic failure, due to an extensive genotypic resistance to all available antiretroviral compounds.

scholarly journals Chronic Cystoisospora belli infection in a Colombian patient living with HIV and poor adherence to highly active antiretroviral therapy

Biomédica ◽  
2021 ◽  
Vol 41 (Supl. 1) ◽  
pp. 17-22
Author(s):  
Ana Luz Galván-Díaz ◽  
Juan Carlos Alzate ◽  
Esteban Villegas ◽  
Sofía Giraldo ◽  
Jorge Botero ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Diarrheal Disease ◽  
Opportunistic Infections ◽  
Poor Adherence ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Living With Hiv

Cystoisospora belli is an intestinal Apicomplexan parasite associated with diarrheal illness and disseminated infections in humans, mainly immunocompromised individuals such as those living with the human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). An irregular administration of highly active antiretroviral therapy (HAART) in HIV patients may increase the risk of opportunistic infections like cystoisosporiasis.We describe here a case of C. belli infection in a Colombian HIV patient with chronic gastrointestinal syndrome and poor adherence to HAART. His clinical and parasitological cure was achieved with trimethoprim-sulfamethoxazole treatment. Although a reduction in the number of C. belli cases has been observed since the use of HAART, this parasite still has to be considered as a differential diagnosis of diarrheal disease in HIV/AIDS patients.Effective interventions enhancing adherence to HAART should be included in HIV patient care programs.

scholarly journals Neopterin and Biochemical Parameters as Indicators of Predicting HIV Disease Progression and Treatment Response: A Cross-sectional Study in Ghana

2019 ◽  
pp. 1-10
Author(s):  
Louis Boafo Kwantwi ◽  
Christian Obirikorang ◽  
Margaret Agyei Frempong ◽  
Dan Yedu Quansah
Keyword(s):  
Disease Progression ◽  
Highly Active Antiretroviral Therapy ◽  
Biochemical Parameters ◽  
Cross Sectional Study ◽  
Hiv Disease ◽  
Sectional Study ◽  
Cross Sectional ◽  
Highly Active ◽  
Hiv Seropositive ◽  
Therapy Treatment

Background: Surrogate markers have been identified to play significant role in the pathogenesis and prognosis of HIV infection. However, there is limited data on the utility of neopterin estimation in HIV infection. Therefore, the study sought to measure and ascertains the trends of serum neopterin and other biochemical parameters as indicators of predicting HIV disease progression and treatment response among HIV seropositive individuals. Methods: A cross-sectional study with 298 HIV seropositive individuals consisting of 165 HIV on highly active antiretroviral treatment and 136 naïve highly active antiretroviral patients. Venous blood was drawn for the assay of neopterin and the other biochemical parameters. Results: Neopterin was significantly lower (P<0.0001) in patients in the highly active antiretroviral therapy than those in the naïve highly active antiretroviral therapy group. Serum neopterin increased as the disease progresses and decreased as the duration of the therapy treatment increased (p=0.0001). At a cut of point of 54.5 nmol/L, neopterin gave a sensitivity of 97.5%, specificity of 95.9% and an area under the curve of 0.99. Conclusion: Neopterin has shown to be to be good marker in predicting HIV disease progression especially in patients with CD4 counts less than 200mm-3 and a useful indicator of patient’s response to therapy treatment.

scholarly journals Invasive fungal infections in the immunocompromised host: Mechanistic insights in an era of changing immunotherapeutics

2019 ◽  
Vol 57 (Supplement_3) ◽  
pp. S307-S317 ◽  
Author(s):  
Christopher P Eades ◽  
Darius P H Armstrong-James
Keyword(s):  
Intracellular Signaling ◽  
Fungal Pathogens ◽  
Opportunistic Infections ◽  
Fungal Infections ◽  
Immunocompromised Host ◽  
Adaptive Immune ◽  
Mechanistic Approach ◽  
Molecular Immunology ◽  
Nonspecific Cytotoxicity ◽  
Small Molecular Inhibitors

AbstractThe use of cytotoxic chemotherapy in the treatment of malignant and inflammatory disorders is beset by considerable adverse effects related to nonspecific cytotoxicity. Accordingly, a mechanistic approach to therapeutics has evolved in recent times with small molecular inhibitors of intracellular signaling pathways involved in disease pathogenesis being developed for clinical use, some with unparalleled efficacy and tolerability. Nevertheless, there are emerging concerns regarding an association with certain small molecular inhibitors and opportunistic infections, including invasive fungal diseases. This is perhaps unsurprising, given that the molecular targets of such agents play fundamental and multifaceted roles in orchestrating innate and adaptive immune responses. Nevertheless, some small molecular inhibitors appear to possess intrinsic antifungal activity and may therefore represent novel therapeutic options in future. This is particularly important given that antifungal resistance is a significant, emerging concern. This paper is a comprehensive review of the state-of-the-art in the molecular immunology to fungal pathogens as applied to existing and emerging small molecular inhibitors.

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