HIV and fungal priority pathogens

Area of Science:

• Mycology
• Infectious Diseases
• Public Health

Background:

• Invasive fungal infections (IFIs) pose a significant threat, especially to individuals with advanced HIV.
• Opportunistic fungal pathogens are a major cause of morbidity and mortality in this population.
• Global health initiatives are increasingly focusing on fungal diseases.

Purpose of the Study:

• To highlight the critical role of four specific opportunistic fungal pathogens in HIV-associated IFIs.
• To emphasize the impact of these pathogens on global health, particularly in low- and middle-income countries.
• To advocate for improved diagnostics, surveillance, and public health strategies.

Main Methods:

• Review of the World Health Organization's Fungal Priority Pathogens List (FPPL).
• Identification of fungal pathogens listed in the FPPL that are significant causes of IFIs in people with advanced HIV.
• Analysis of the epidemiological impact and geographic distribution of these pathogens.

Main Results:

• The WHO FPPL identifies 19 priority fungal pathogens.
• Four pathogens—Cryptococcus neoformans, Histoplasma spp., Pneumocystis jirovecii, and Talaromyces marneffei—are particularly relevant to HIV-associated IFIs.
• These four pathogens are disproportionately affecting individuals in low- and middle-income countries.

Conclusions:

• Cryptococcus neoformans, Histoplasma spp., Pneumocystis jirovecii, and Talaromyces marneffei are critical threats to people with advanced HIV.
• Urgent need for enhanced diagnostics, surveillance, innovation support, and public health interventions.
• Addressing these fungal infections is crucial for reducing HIV-associated mortality.