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

  • HIV/AIDS (C Yoon, Section Editor)
  • Published:
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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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Authors and Affiliations

  1. University of Georgia College of Pharmacy, 1000 Jefferson Street, Albany, GA, 31701, USA

    Daniel B. Chastain

  2. University of Colorado Denver, Anschutz Medical Campus, Denver, CO, USA

    Andrés F. Henao-Martínez & Carlos Franco-Paredes

  3. Hospital Infantil de Mexico, Federico Gomez, Mexico City, Mexico

    Carlos Franco-Paredes

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  1. Daniel B. Chastain
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Chastain, D.B., Henao-Martínez, A.F. & Franco-Paredes, C. Opportunistic Invasive Mycoses in AIDS: Cryptococcosis, Histoplasmosis, Coccidiodomycosis, and Talaromycosis. Curr Infect Dis Rep 19, 36 (2017). https://doi.org/10.1007/s11908-017-0592-7

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