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Invasive aspergillosis in AIDS.

N Singh1, V L Yu, J D Rihs

  • 1University of Pittsburgh, Pa.

Southern Medical Journal
|July 1, 1991
PubMed
Summary

Invasive aspergillosis, a fungal infection, is rare in individuals with acquired immunodeficiency syndrome (AIDS). This study highlights that aspergillosis is not an AIDS-related opportunistic infection.

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Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Immunocompromised Hosts

Background:

  • Invasive pulmonary aspergillosis (IPA) is a serious fungal infection.
  • Patients with Human Immunodeficiency Virus (HIV) infection are susceptible to opportunistic infections.
  • The relationship between HIV/AIDS and invasive aspergillosis requires further clarification.

Observation:

  • Two HIV-infected patients with IPA were identified, one with neutropenia and another on corticosteroids.
  • A literature review identified 17 additional cases, with 79% having known risk factors like neutropenia or corticosteroid use.
  • Pulmonary involvement was most common (75%), with central nervous system (CNS) involvement observed in 55% of cases.

Findings:

  • Invasive aspergillosis is relatively rare in patients with acquired immunodeficiency syndrome (AIDS), suggesting that the immunologic defect of AIDS is not a primary driver.
  • Central nervous system involvement in HIV-infected patients with invasive aspergillosis appears more frequent than in other immunosuppressed populations.
  • Transbronchial biopsy is a useful diagnostic tool for pulmonary aspergillosis.

Implications:

  • Aspergillosis should not be considered an AIDS-defining opportunistic infection.
  • Early diagnosis and treatment are crucial, although current therapies like amphotericin B have shown limited efficacy, with prognosis remaining poor.
  • Further research is needed to evaluate combination therapies, such as amphotericin B with rifampin or itraconazole.

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