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Current Infectious Disease Reports
Published in: Current Infectious Disease Reports 10/2017

01-10-2017 | HIV/AIDS (C Yoon, Section Editor)

Opportunistic Invasive Mycoses in AIDS: Cryptococcosis, Histoplasmosis, Coccidiodomycosis, and Talaromycosis

Authors: Daniel B. Chastain, Andrés F. Henao-Martínez, Carlos Franco-Paredes

Published in: Current Infectious Disease Reports | Issue 10/2017

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Abstract

Purpose of Review

The goal of this review is to provide an update on the epidemiology, diagnosis, and treatment of opportunistic fungal infections in patients with human immunodeficiency virus (HIV) infection including Cryptococcus spp., Histoplasma spp., Coccidioides spp., and Talaromyces marneffei, formerly Penicillium marneffei.

Recent Findings

In many settings, despite increasing roll out of antiretroviral therapy (ART), opportunistic invasive mycoses produce a substantial burden of disease. The prevalence of specific fungal pathogens depends on their endemicity. Viral suppression achieved by greater access to ART and increased the availability of point-of-care testing with rapid diagnostic tests (RDTs) aid to curtail the associated fungi morbidity. RDTs allow earlier screening to preemptively initiate treatment of opportunistic fungal pathogens. Identifying asymptomatic cryptococcal infection before starting ART is crucial in reducing the risk of the immune reconstitution inflammatory syndrome (IRIS).

Summary

There is an urgent need to decrease the burden of opportunistic invasive fungal infections in individuals with HIV/AIDS through different interventions: (a) continue to expand the deployment of ART to the most affected populations to achieve viral suppression; (b) ensure early diagnosis of fungal pathogen with point-of-care testing; (c) improve fungal diagnostic capacity in areas with the highest burden of AIDS-related mycoses; and (d) increased availability of existing antifungal drugs to optimally treat these infections.
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Metadata
Title
Opportunistic Invasive Mycoses in AIDS: Cryptococcosis, Histoplasmosis, Coccidiodomycosis, and Talaromycosis
Authors
Daniel B. Chastain
Andrés F. Henao-Martínez
Carlos Franco-Paredes
Publication date
01-10-2017
Publisher
Springer US
Published in
Current Infectious Disease Reports / Issue 10/2017
Print ISSN: 1523-3847
Electronic ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-017-0592-7

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