Paracoccidioidomycosis in people living with HIV/AIDS: A historical retrospective cohort study in a national reference center for infectious diseases, Rio de Janeiro, Brazil.
Paracoccidioidomycosis (PCM) is one of the main endemic systemic mycoses in Latin America, usually occurring in rural areas. When PCM occurs simultaneously with underlying immunosuppressive conditions, it can present as an opportunistic disease. Between 2000 and 2017, literature reported around 200...
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ftdoajarticles:oai:doaj.org/article:9a68aab36a6d472c80b7db4e13fcb9da 2023-05-15T15:12:12+02:00 Paracoccidioidomycosis in people living with HIV/AIDS: A historical retrospective cohort study in a national reference center for infectious diseases, Rio de Janeiro, Brazil. Eduardo Mastrangelo Falcão Priscila Marques de Macedo Dayvison Francis Saraiva Freitas Andréa d'Avila Freitas Beatriz Grinsztejn Valdiléa Gonçalves Veloso Rodrigo Almeida-Paes Antonio Carlos Francesconi do Valle 2022-06-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0010529 https://doaj.org/article/9a68aab36a6d472c80b7db4e13fcb9da EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0010529 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010529 https://doaj.org/article/9a68aab36a6d472c80b7db4e13fcb9da PLoS Neglected Tropical Diseases, Vol 16, Iss 6, p e0010529 (2022) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2022 ftdoajarticles https://doi.org/10.1371/journal.pntd.0010529 2022-12-30T23:19:49Z Paracoccidioidomycosis (PCM) is one of the main endemic systemic mycoses in Latin America, usually occurring in rural areas. When PCM occurs simultaneously with underlying immunosuppressive conditions, it can present as an opportunistic disease. Between 2000 and 2017, literature reported around 200 PCM cases in people living with HIV/AIDS (PLWHA). To address research gaps on this co-infection and to study its possible temporal changes in the last decade, we performed an active co-infection case search on the HIV/AIDS and PCM cohorts from a Brazilian reference center database from 1989 to 2019. We found 20 PLWHA among 684 PCM patients (2.92%), predominantly male (70.0%) and urban workers (80.0%). The median age of patients was higher in the 2010-2019 decade (p = 0.006). The occurrence of PCM in PLWHA was lower when compared with other fungal diseases. Although 50.0% of the patients had already been diagnosed with HIV infection and presented CD4+ T cell counts greater than 200/mm3 at the time of PCM diagnosis, the suspicion of immunosuppression in the context of atypical and more severe clinical forms of PCM revealed the diagnosis of HIV infection in 35.0% of the patients. Two (10.0%) patients had an evolution compatible with immune reconstitution inflammatory syndrome (IRIS) after starting antiretroviral therapy (ART).We highlight the importance of considering a PCM diagnosis in PLWHA to prevent a late-onset treatment and progression to severe manifestations and unfavorable outcomes. In addition, HIV investigation is recommended in PCM patients, especially those with atypical and more severe clinical presentations. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 16 6 e0010529 |
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Directory of Open Access Journals: DOAJ Articles |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Eduardo Mastrangelo Falcão Priscila Marques de Macedo Dayvison Francis Saraiva Freitas Andréa d'Avila Freitas Beatriz Grinsztejn Valdiléa Gonçalves Veloso Rodrigo Almeida-Paes Antonio Carlos Francesconi do Valle Paracoccidioidomycosis in people living with HIV/AIDS: A historical retrospective cohort study in a national reference center for infectious diseases, Rio de Janeiro, Brazil. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Paracoccidioidomycosis (PCM) is one of the main endemic systemic mycoses in Latin America, usually occurring in rural areas. When PCM occurs simultaneously with underlying immunosuppressive conditions, it can present as an opportunistic disease. Between 2000 and 2017, literature reported around 200 PCM cases in people living with HIV/AIDS (PLWHA). To address research gaps on this co-infection and to study its possible temporal changes in the last decade, we performed an active co-infection case search on the HIV/AIDS and PCM cohorts from a Brazilian reference center database from 1989 to 2019. We found 20 PLWHA among 684 PCM patients (2.92%), predominantly male (70.0%) and urban workers (80.0%). The median age of patients was higher in the 2010-2019 decade (p = 0.006). The occurrence of PCM in PLWHA was lower when compared with other fungal diseases. Although 50.0% of the patients had already been diagnosed with HIV infection and presented CD4+ T cell counts greater than 200/mm3 at the time of PCM diagnosis, the suspicion of immunosuppression in the context of atypical and more severe clinical forms of PCM revealed the diagnosis of HIV infection in 35.0% of the patients. Two (10.0%) patients had an evolution compatible with immune reconstitution inflammatory syndrome (IRIS) after starting antiretroviral therapy (ART).We highlight the importance of considering a PCM diagnosis in PLWHA to prevent a late-onset treatment and progression to severe manifestations and unfavorable outcomes. In addition, HIV investigation is recommended in PCM patients, especially those with atypical and more severe clinical presentations. |
format |
Article in Journal/Newspaper |
author |
Eduardo Mastrangelo Falcão Priscila Marques de Macedo Dayvison Francis Saraiva Freitas Andréa d'Avila Freitas Beatriz Grinsztejn Valdiléa Gonçalves Veloso Rodrigo Almeida-Paes Antonio Carlos Francesconi do Valle |
author_facet |
Eduardo Mastrangelo Falcão Priscila Marques de Macedo Dayvison Francis Saraiva Freitas Andréa d'Avila Freitas Beatriz Grinsztejn Valdiléa Gonçalves Veloso Rodrigo Almeida-Paes Antonio Carlos Francesconi do Valle |
author_sort |
Eduardo Mastrangelo Falcão |
title |
Paracoccidioidomycosis in people living with HIV/AIDS: A historical retrospective cohort study in a national reference center for infectious diseases, Rio de Janeiro, Brazil. |
title_short |
Paracoccidioidomycosis in people living with HIV/AIDS: A historical retrospective cohort study in a national reference center for infectious diseases, Rio de Janeiro, Brazil. |
title_full |
Paracoccidioidomycosis in people living with HIV/AIDS: A historical retrospective cohort study in a national reference center for infectious diseases, Rio de Janeiro, Brazil. |
title_fullStr |
Paracoccidioidomycosis in people living with HIV/AIDS: A historical retrospective cohort study in a national reference center for infectious diseases, Rio de Janeiro, Brazil. |
title_full_unstemmed |
Paracoccidioidomycosis in people living with HIV/AIDS: A historical retrospective cohort study in a national reference center for infectious diseases, Rio de Janeiro, Brazil. |
title_sort |
paracoccidioidomycosis in people living with hiv/aids: a historical retrospective cohort study in a national reference center for infectious diseases, rio de janeiro, brazil. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2022 |
url |
https://doi.org/10.1371/journal.pntd.0010529 https://doaj.org/article/9a68aab36a6d472c80b7db4e13fcb9da |
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Arctic |
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Arctic |
genre |
Arctic |
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Arctic |
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PLoS Neglected Tropical Diseases, Vol 16, Iss 6, p e0010529 (2022) |
op_relation |
https://doi.org/10.1371/journal.pntd.0010529 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010529 https://doaj.org/article/9a68aab36a6d472c80b7db4e13fcb9da |
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https://doi.org/10.1371/journal.pntd.0010529 |
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PLOS Neglected Tropical Diseases |
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6 |
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e0010529 |
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