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Recent advances in cryptococcosis, candidiasis and coccidioidomycosis complicating HIV infection
R Kappe1, S Levitz, T S Harrison
1Hygiene Institute of the University of Heidelberg, Germany. un691rk@genius.embnet.dkfz-heidelberg.de
Abstract:
Concomitant with the decline in CD4+ T-cells seen as human immunodeficiency virus (HIV) infection progresses, the prevalence of opportunistic mycoses increases dramatically. This article reviews selected recent advances in our understanding of the immunology, molecular epidemiology and treatment of fungal infections in patients infected with HIV. For cryptococcosis, studies are reported on how HIV infection affects the immune response to Cryptococcus neoformans and, conversely, how stimulation with C. neoformans induces HIV production from latently HIV-infected cells. In addition, studies are presented examining the efficacy of triple combination antimycotic chemotherapy in cryptococcosis. For candidosis, investigations into genetic profiles of Candida albicans isolates obtained from patients, with resistance to antifungal agents, are demonstrated. Finally, for coccidioidomycosis, prospective studies are presented examining the clinical, epidemiological and immunological characteristics of a cohort of HIV-infected subjects residing in an endemic area.
Insights
Human immunodeficiency virus (HIV) infection increases opportunistic fungal infections. This review covers advances in the immunology, epidemiology, and treatment of fungal infections in people with HIV.
Area of Science:
- Medical Mycology
- Immunology
- Infectious Diseases
Background:
- HIV infection leads to a decline in CD4+ T-cells, increasing susceptibility to opportunistic mycoses.
- Fungal infections pose a significant threat to individuals with advanced HIV.
- Understanding these infections is crucial for managing patient health.
Purpose of the Study:
- To review recent advances in the understanding of fungal infections in HIV-infected patients.
- To highlight progress in immunology, molecular epidemiology, and treatment strategies.
- To consolidate current knowledge on cryptococcosis, candidosis, and coccidioidomycosis in this population.
Main Methods:
- Review of recent studies on fungal infections in HIV.
- Analysis of immunological interactions between HIV and fungal pathogens.
- Examination of molecular epidemiology and genetic profiles of resistant fungal isolates.
- Evaluation of treatment efficacy, including combination chemotherapy.
Main Results:
- Studies show how HIV impacts immune responses to Cryptococcus neoformans and vice versa.
- Research investigates antifungal resistance in Candida albicans isolates from HIV patients.
- Prospective studies examine clinical, epidemiological, and immunological features of coccidioidomycosis in HIV-infected individuals.
Conclusions:
- Advances in understanding fungal infections in HIV are improving patient care.
- Further research into immunology, resistance, and treatment is essential.
- Integrated approaches are needed to combat opportunistic mycoses in HIV-infected populations.