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Imported Acquired Immunodeficiency Syndrome―Related Histoplasmosis in Metropolitan France: A Comparison of Pre-Highly Active Anti-Retroviral Therapy and Highly Active Anti-Retroviral Therapy Eras
Ist Teil von
The American journal of tropical medicine and hygiene, 2011-11, Vol.85 (5), p.934-941
Ort / Verlag
Deerfield, IL: American Society of Tropical Medecine and Hygiene
Erscheinungsjahr
2011
Quelle
MEDLINE
Beschreibungen/Notizen
Histoplasma capsulatum var. capsulatum infection is rare outside disease-endemic areas. Clinical presentation and outcome of acquired immunodeficiency syndrome-related histoplasmosis are unknown in non-endemic areas with wide access to highly active anti-retroviral therapy (HAART). Retrospective analysis of cases recorded at the French National Reference Center for Mycoses and Antifungals during two decades: pre-HAART (1985-1994) and HAART (1997-2006). Clinical features and outcome of all adults with proven acquired immunodeficiency syndrome-related histoplasmosis were compared between the two periods. One hundred four patients were included (40 during the pre-HAART era and 64 during the HAART era). Diagnosis was established a mean of 62 days after onset of symptoms. One-year overall mortality rates decreased from 53% (pre-HAART era) to 22% (HAART era). Diagnosis during the pre-HAART era and an older age were the only independent factors associated with death. Histoplasmosis is a rare invasive fungal infection outside disease-endemic areas. Its prognosis improved significantly during the HAART era.