Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
Current Infectious Disease Reports
Erschienen in: Current Infectious Disease Reports 10/2017

01.10.2017 | HIV/AIDS (C Yoon, Section Editor)

Opportunistic Invasive Mycoses in AIDS: Cryptococcosis, Histoplasmosis, Coccidiodomycosis, and Talaromycosis

verfasst von: Daniel B. Chastain, Andrés F. Henao-Martínez, Carlos Franco-Paredes

Erschienen in: Current Infectious Disease Reports | Ausgabe 10/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

The goal of this review is to provide an update on the epidemiology, diagnosis, and treatment of opportunistic fungal infections in patients with human immunodeficiency virus (HIV) infection including Cryptococcus spp., Histoplasma spp., Coccidioides spp., and Talaromyces marneffei, formerly Penicillium marneffei.

Recent Findings

In many settings, despite increasing roll out of antiretroviral therapy (ART), opportunistic invasive mycoses produce a substantial burden of disease. The prevalence of specific fungal pathogens depends on their endemicity. Viral suppression achieved by greater access to ART and increased the availability of point-of-care testing with rapid diagnostic tests (RDTs) aid to curtail the associated fungi morbidity. RDTs allow earlier screening to preemptively initiate treatment of opportunistic fungal pathogens. Identifying asymptomatic cryptococcal infection before starting ART is crucial in reducing the risk of the immune reconstitution inflammatory syndrome (IRIS).

Summary

There is an urgent need to decrease the burden of opportunistic invasive fungal infections in individuals with HIV/AIDS through different interventions: (a) continue to expand the deployment of ART to the most affected populations to achieve viral suppression; (b) ensure early diagnosis of fungal pathogen with point-of-care testing; (c) improve fungal diagnostic capacity in areas with the highest burden of AIDS-related mycoses; and (d) increased availability of existing antifungal drugs to optimally treat these infections.
Literatur
1.
Haddad NE, Powderly WG. The changing face of mycoses in patients with HIV/AIDS. AIDS Read. 2001;11(7):375–8.
2.
3.
Buchacz K, Lau B, Jing Y, Bosch R, Abraham AG, Gill MJ, et al. Incidence of AIDS-defining opportunistic infections in a multicohort analysis of HIV-infected persons in the United States and Canada, 2000–2010. J Infect Dis. 2016;214(6):8862–72.CrossRef
4.
Brown GD, Denning DW, Gow NA, Levitz SM, Netea MG, White TC. Hidden killers: human fungal infections. Sci Transl Med. 2012;4:165rv113.CrossRef
5.
Masur H. HIV related opportunistic infections are still relevant in 2015. Top Antivir Med. 2015;23:116–9.PubMed
6.
7.
Ruhnke M. Mucosal and systemic fungal infections in patients with AIDS: prophylaxis and treatment. Drugs. 2004;64(11):1163–80.CrossRefPubMed
8.
9.
Bowen LN, Smith B, Reich D, Quezado M, Nath A. HIV-associated opportunistic CNS infections: pathophysiology, diagnosis, and treatment. Nat Rev Neurol. 2016;12(11):662–74.CrossRefPubMed
10.
• Armstrong-James D, Bicanic T, Brown GD, Hoving JC, Meintjes G, Nielsen K, et al. AIDS-related mycoses: current progress in the field and future priorities. Trends Microbiol. 2017;25(6):428–30. This article provides a summary of advances in research in addressing AIDS-related mycoses and next steps needed to close the gap. CrossRefPubMed
11.
•• Armstrong-James D, Meintjes G, Brown GD. A neglected epidemic: fungal infections in HIV/AIDS. Trends Microbiol. 2014;22:120–7. This article summarizes the epidemiology, clinical aspects, and treatment of the major AIDS-related mycoses. CrossRefPubMed
12.
13.
14.
Lazera MS, Salmito Cavalcanti MA, Londero AT, Trilles L, Nishikawa MM, Wanke B. Possible primary ecological niche of Cryptococcus neoformans. Med Mycol. 2000;38(5):379–83.CrossRefPubMed
15.
16.
Park BJ, Wannemuehler KA, Marston BJ, Govender N, Pappas PG, Chiller TM. Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS. AIDS. 2009;23(4):525–30.CrossRefPubMed
17.
French N, Gray K, Watera C, et al. Cryptococcal infection in a cohort of HIV-1-infected Ugandan adults. AIDS. 2002;16:1031–8.CrossRefPubMed
18.
Nalintya E, Kiggundu R, Meya D. Evolution of cryptococcal antigen testing: what is new? Curr Fungal Infect Rep. 2016;10(2):62–7.CrossRef
19.
Tanner DC, Weinstein MP, Fedorciw B, Joho KL, Thorpe JJ, Reller L. Comparison of commercial kits for detection of cryptococcal antigen. J Clin Microbiol. 1994;32(7):1680–4.PubMedPubMedCentral
20.
Jarvis JN, Percival A, Bauman S, Pelfrey J, Meintjes G, Williams GN, et al. Evaluation of a novel point-of-care cryptococcal antigen test on serum, plasma, and urine from patients with HIV-associated cryptococcal meningitis. Clin Infect Dis. 2011;53(10):1019–23.CrossRefPubMedPubMedCentral
21.
Boulware DR, Rolfes MA, Rajasingham R, von Hohenberg M, Qin Z, Taseera K, et al. Multisite validation of cryptococcal antigen lateral flow assay and quantification by laser thermal contrast. Emerg Infect Dis. 2014;20(1):45–53.CrossRefPubMedPubMedCentral
22.
Williams DA, Kiiza T, Kwizera R, et al. Evaluation of fingerstick cryptococcal antigen lateral flow assay in HIV-infected persons: a diagnostic accuracy study. Clin Infect Dis. 2015;61:464–7.CrossRefPubMedPubMedCentral
23.
Meya D, Rajasingham R, Nalintya E, et al. Preventing cryptococcosis—shifting the paradigm in the era of highly active antiretroviral therapy. Curr Trop Med Rep. 2015;2:81–9.CrossRefPubMedPubMedCentral
24.
Butler EK, Boulware DR, Bohjanen PR, Meya DB. Long term 5-year survival of persons with cryptococcal meningitis or asymptomatic subclinical antigenemia in Uganda. PLoS One. 2012;7(12):e51291.CrossRefPubMedPubMedCentral
25.
Mfinanga S, Chanda D, Kivuyo SL, Guinness L, Bottomley C, REMSTART trial team, et al. Cryptococcal meningitis screening and community-based early adherence support in people with advanced HIV infection starting antiretroviral therapy in Tanzania and Zambia: an open-label, randomised controlled trial. Lancet. 2015;385(9983):2173–82.CrossRefPubMed
26.
27.
DHHS Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Available at http://​aidsinfo.​nih.​gov/​contentfiles/​lvguidelines/​adult_​oi.​pdf. Accessed April 28, 2017.
28.
Farmer S, Komorowski R. Histologic response to capsule-deficient Cryptococcus neoformans. Arch Pathol. 1973;96:383–7.PubMed
29.
Opota O, Desgraz B, Kenfak A, et al. Cryptococcus neoformans meningitis with negative cryptococcal antigen: evaluation of a new immunochromatographic detection assay. New Microbes New Infect. 2014;4:1–4.CrossRefPubMedPubMedCentral
30.
Blevins LB, Fenn J, Segal H, Newcomb-Gayman P, Carroll KC. False-positive cryptococcal antigen latex agglutination caused by disinfectants and soaps. J Clin Microbiol. 1995;33(6):1674–5.PubMedPubMedCentral
31.
Wilson DA, Sholtis M, Parshall S, Hall GS, Procop GW. False-positive cryptococcal antigen test associated with use of BBL Port-a-cul transport vials. J Clin Microbiol. 2011;49(2):702–3.CrossRefPubMedPubMedCentral
32.
Bratton EW, El Husseini N, Chastain CA, Lee MS, Poole C, Stürmer T, et al. Approaches to antifungal therapies and their effectiveness among patients with cryptococcosis. Antimicrob Agents Chemother. 2013;57(6):2485–95.CrossRefPubMedPubMedCentral
33.
34.
Beardsley J, Wolbers M, Kibengo FM, et al. Adjunctive dexamethasone in HIV-associated cryptococcal meningitis. N Engl J Med. 2016;374(6):542–54.CrossRefPubMedPubMedCentral
35.
Franco-Paredes C, Chastain DB, Rodriguez-Morales AJ, Marcos LA. Cryptococcal meningoencephalitis in HIV/AIDS: when to start antiretroviral therapy? Ann Clin Microbiol Antimicrob. 2017;16(1):9.CrossRefPubMedPubMedCentral
36.
Rolfes MA, Hullsiek KH, Rhein J, Nabeta HW, Taseera K, Schutz C, et al. The effect of therapeutic lumbar punctures on acute mortality from cryptococcal meningitis. Clin Infect Dis. 2014;59(11):1607–14.CrossRefPubMedPubMedCentral
37.
Shelburne SA 3rd, Darcourt J, White AC Jr, et al. The role of immune reconstitution inflammatory syndrome in AIDS-related Cryptococcus neoformans disease in the era of highly active antiretroviral therapy. Clin Infect Dis. 2005;40(7):1049–52.CrossRefPubMed
38.
Muller M, Wandel S, Colebunders R, et al. Immune reconstitution inflammatory syndrome in patients starting antiretroviral therapy for HIV infection: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10(4):251–61.CrossRefPubMedPubMedCentral
39.
Günthard HF, Saag MS, Benson CA, et al. Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2016 recommendations of the international antiviral society-USA panel. JAMA. 2016;316(2):191–210.CrossRefPubMedPubMedCentral
40.
Boulware DR, Meya DB, Muzoora C, et al. Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis. N Engl J Med. 2014;370(26):2487–98.CrossRefPubMedPubMedCentral
41.
42.
McKinsey DS, Spiegel RA, Hutwagner L, et al. Prospective study of histoplasmosis in patients infected with human immunodeficiency virus: incidence, risk factors, and pathophysiology. Clin Infect Dis. 1997;24(6):1195–203.CrossRefPubMed
43.
Adenis AA, Aznar C, Couppie P. Histoplasmosis in HIV-infected patients: a review of new developments and remaining gaps. Curr Trop Med Rep. 2014;1(2):119–28.PubMedPubMedCentral
44.
Baddley JW, Sankara IR, Rodriquez JM, Pappas PG, Many WJ Jr. Histoplasmosis in HIV-infected patients in a southern regional medical center: poor prognosis in the era of highly active antiretroviral therapy. Diagn Microbiol Infect Dis. 2008;62(2):151–6.CrossRefPubMed
45.
Nacher M, Adenis A, Blanchet D, Vantilcke V, Demar M, Basurko C, et al. Risk factors for disseminated histoplasmosis in a cohort of HIV-infected patients in French Guiana. PLoS Negl Trop Dis. 2014;8(1):e2638.CrossRefPubMedPubMedCentral
46.
Hajjeh RA, Pappas PG, Henderson H, Lancaster D, Bamberger DM, Skahan KJ, et al. Multicenter case-control study of risk factors for histoplasmosis in human immunodeficiency virus-infected persons. Clin Infect Dis. 2001;32(8):1215–20.CrossRefPubMed
47.
Hage CA, Ribes JA, Wengenack NL, Baddour LM, Assi M, McKinsey DS, et al. A multicenter evaluation of tests for diagnosis of histoplasmosis. Clin Infect Dis. 2011;53(5):448–54.CrossRefPubMed
48.
Wheat LJ. Current diagnosis of histoplasmosis. Trends Microbiol. 2003;11(10):488–94.CrossRef
49.
Wheat LJ, Freifeld AG, Kleiman MB, Baddley JW, McKinsey DS, Loyd JE, et al. Infectious Diseases Society of America. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis. 2007;45(7):807–25.CrossRefPubMed
50.
Theel ES, Harrin JA, Dababneh AS, Rollins LO, Bestrom JE, Jespersen DJ. Reevaluation of commercial reagents for detection of Histoplasma capsulatum antigen in urine. J Clin Microb. 2015;53(4):1198–203.CrossRef
51.
Drew RH. Pharmacotherapy of disseminated histoplasmosis in patients with AIDS. Ann Pharmacother. 1993;27(12):1510–8.CrossRefPubMed
52.
Kiggundu R, Nabeta HW, Okia R, Rhein J, Lukande R. Unmasking histoplasmosis immune reconstitution inflammatory syndrome in a patient recently started on antiretroviral therapy. Autops Case Rep. 2016;6(4):27–33.CrossRefPubMedPubMedCentral
53.
Nguyen C, Barker BM, Hoover S, Nix DE, Ampel NM, Frelinger JA, et al. Recent advances in our understanding of the environmental, epidemiological, immunological, and clinical dimensions of coccidioidomycosis. Clin Microbiol Rev. 2013;26(3):505–25.CrossRefPubMedPubMedCentral
54.
Litvintseva AP, Marsden-Haug N, Hurst S, Hill H, Gade L, Driebe EM, et al. Valley fever: finding new places for an old disease: Coccidioides immitis found in Washington state soil associated with recent human infection. Clin Infect Dis. 2015;60(1):e1–3.CrossRefPubMed
55.
Saubolle MA, McKellar PP, Sussland D. Epidemiologic, clinical, and diagnostic aspects of coccidioidomycosis. J Clin Microbiol. 2007;45(1):26–30.CrossRefPubMed
56.
Ampel NM. Coccidioidomycosis in persons infected with HIV type 1. Clin Infect Dis. 2005;41(8):1174–8.CrossRefPubMed
57.
Kassis C, Zaidi S, Kuberski T, et al. Role of coccidioides antigen testing in the cerebrospinal fluid for the diagnosis of coccidioidal meningitis. Clin Infect Dis. 2015;61(10):1521–6.CrossRefPubMed
58.
59.
Galgiani JN, Ampel NM, Blair JE, Catanzaro A, Geertsma F, Hoover SE, et al. 2016 Infectious Diseases Society of America (IDSA) clinical practice guideline for the treatment of coccidioidomycosis. Clin Infect Dis. 2016;63(6):e112–46.CrossRefPubMed
60.
Thompson G 3rd, Wang S, Bercovitch R, Bolaris M, Van Den Akker D, Taylor S, et al. Routine CSF analysis in coccidioidomycosis is not required. PLoS One. 2013;8(5):e64249.CrossRefPubMedPubMedCentral
61.
Thompson GR 3rd, Rendon A, Ribeiro Dos Santos R, Queiroz-Telles F, Ostrosky-Zeichner L, Azie N, et al. Isavuconazole treatment of cryptococcosis and dimorphic mycoses. Clin Infect Dis. 2016;63(3):356–62.CrossRefPubMedPubMedCentral
62.
Schein R, Homans J, Larsen RA, Neely M. Posaconazole for chronic refractory coccidioidal meningitis. Clin Infect Dis. 2011;53(12):1252–4.CrossRefPubMed
63.
D'Avino A, Di Giambenedetto S, Fabbiani M, Farina S. Coccidioidomycosis of cervical lymph nodes in an HIV-infected patient with immunologic reconstitution on potent HAART: a rare observation in a nonendemic area. Diagn Microbiol Infect Dis. 2012;72(2):185–7.CrossRefPubMed
64.
Trible R, Edgerton N, Hayek S, Winkel D, Anderson AM. Antiretroviral therapy-associated coccidioidal meningitis. Emerg Infect Dis. 2013;19(1):163–5.CrossRefPubMedPubMedCentral
65.
Le T, Wolbers M, Chi NH, Quang VM, Chinh NT, Lan NP, et al. Epidemiology, seasonality, and predictors of outcome of AIDS-associated Penicillium marneffei infection in Ho Chi Minh City, Viet Nam. Clin Infect Dis. 2011;52(7):945–52.CrossRefPubMedPubMedCentral
66.
Gugnani H, Fisher MC, Paliwal-Johsi A, Vanittanakom N, Singh I, Yadav PS. Role of Cannomys badius as a natural animal host of Penicillium marneffei in India. J Clin Microbiol. 2004;42(11):5070–5.CrossRefPubMedPubMedCentral
67.
Chariyalertsak S, Supparatpinyo K, Sirisanthana T, Nelson KE. A controlled trial of itraconazole as primary prophylaxis for systemic fungal infections in patients with advanced human immunodeficiency virus infection in Thailand. Clin Infect Dis. 2002;34(2):277–84.CrossRefPubMed
68.
Hu Y, Zhang J, Li X, et al. Penicillium marneffei infection: an emerging disease in mainland China. Mycopathologia. 2013;175:57–67.CrossRefPubMed
69.
Son VT, Khue PM, Strobel M. Penicilliosis and AIDS in Haiphong, Vietnam: evolution and predictive factors of death. Med Mal Infect. 2014;44:495–501.CrossRefPubMed
70.
Supparatpinyo K, Khamwan C, Baosoung V, Nelson KE, Sirisanthana T. Disseminated Penicillium marneffei infection in southeast Asia. Lancet. 1994;344(8915):110–3.CrossRefPubMed
71.
Ranjana KH, Priyokumar K, Singh TJ, et al. Disseminated Penicillium marneffei infection among HIV-infected patients in Manipur state, India. J Inf Secur. 2002;45(4):268–71.
72.
Wang Y-F, Cai J-P, Wang Y-D, et al. Immunoassays based on Penicillium marneffei Mp1p derived from Pichia pastoris expression system for diagnosis of penicilliosis. PLoS One. 2011;6:e28796.CrossRefPubMedPubMedCentral
73.
Prakit K, Nosanchuk JD, Pruksaphon K, et al. A novel inhibition ELISA for the detection and monitoring of Penicillium marneffei antigen in human serum. Eur J Clin Microbiol Infect Dis. 2016;35:647–56.CrossRefPubMed
74.
Wang Y-F, Xu H-F, Han Z-G, et al. Serological surveillance for Penicillium marneffei infection in HIV-infected patients during 2004–2011 in Guangzhou, China. Clin Microbiol Infect. 2015;21:484–9.CrossRefPubMed
75.
Le T, Kinh NV, Cuc NTK, Tung NLN, Lam NT, Thuy PTT, et al. A Trial of Itraconazole or Amphotericin B for HIV-Associated Talaromycosis. N Engl J Med. 2017;376(24):2329–40.
76.
Manosuthi W, Chaovavanich A, Tansuphaswadikul S, et al. Incidence and risk factors of major opportunistic infections after initiation of antiretroviral therapy among advanced HIV-infected patients in a resource-limited setting. J Inf Secur. 2007;55(5):464–9.
77.
Gupta S, Mathur P, Maskey D, Wig N, Singh S. Immune restoration syndrome with disseminated Penicillium marneffei and cytomegalovirus co-infections in an AIDS patient. AIDS Res Ther. 2007;4:21.CrossRefPubMedPubMedCentral
Metadaten
Titel
Opportunistic Invasive Mycoses in AIDS: Cryptococcosis, Histoplasmosis, Coccidiodomycosis, and Talaromycosis
verfasst von
Daniel B. Chastain
Andrés F. Henao-Martínez
Carlos Franco-Paredes
Publikationsdatum
01.10.2017
Verlag
Springer US
Erschienen in
Current Infectious Disease Reports / Ausgabe 10/2017
Print ISSN: 1523-3847
Elektronische ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-017-0592-7

Weitere Artikel der Ausgabe 10/2017

Current Infectious Disease Reports 10/2017 Zur Ausgabe

Healthcare Associated Infections (G Bearman and D Morgan, Section Editors)

A Roadmap for Reducing Cardiac Device Infections: a Review of Epidemiology, Pathogenesis, and Actionable Risk Factors to Guide the Development of an Infection Prevention Program for the Electrophysiology Laboratory

Antimicrobial Development and Drug Resistance (A Pakyz, Section Editors)

Treatment of Vancomycin-Resistant Enterococci: Focus on Daptomycin

HIV/AIDS (C Yoon, Section Editor)

Primary HIV Infection: Clinical Presentation, Testing, and Treatment

Central Nervous System Infections (K Bloch, Section Editor)

Neurological Presentation of Zika Virus Infection Beyond the Perinatal Period

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise