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Mycoses in AIDS

B Dupont1, H H Crewe Brown, K Westermann

  • 1Unité de Mycologie, Institut Pasteur, H pital Necker, Paris, France. bdupont@pasteur.fr

Medical Mycology
|February 24, 2001
PubMed

Insights

Highly active antiretroviral therapy (HAART) has significantly reduced opportunistic infections (OI) in AIDS patients, making prophylaxis for some infections unnecessary. However, OI epidemiology varies globally, especially in resource-limited settings.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Public Health

Background:

  • Opportunistic infections (OI) are a major concern in patients with acquired immune deficiency syndrome (AIDS).
  • Highly active antiretroviral therapy (HAART) has transformed AIDS management and OI epidemiology.
  • Global access to HAART is unequal, leading to disparate OI patterns.

Purpose of the Study:

  • To analyze the changing epidemiology of OI in AIDS patients on HAART.
  • To evaluate the impact of HAART on OI incidence and antifungal resistance.
  • To compare OI epidemiology in high-income versus low-income settings.

Main Methods:

  • Review of epidemiological data on OI in AIDS patients.
  • Analysis of clinical outcomes related to OI and antifungal resistance.
  • Comparative analysis of OI patterns in different healthcare settings.

Main Results:

  • A significant decrease in both minor and major OI was observed in patients receiving HAART.
  • Clinical resistance of thrush to antifungal agents has become rare.
  • Prophylaxis for Pneumocystis carinii pneumonia can be discontinued, but recommendations for other OI remain unclear.

Conclusions:

  • HAART has dramatically altered OI epidemiology, reducing their incidence and severity.
  • Antifungal resistance in common OI like thrush has decreased with HAART.
  • Disparities in HAART access create vastly different OI challenges in various global regions, necessitating tailored public health strategies.

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