Recent advances in cryptococcosis, candidiasis and coccidioidomycosis complicating HIV infection.
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.
Kappe
R
R
Hygiene Institute of the University of Heidelberg, Germany. un691rk@genius.embnet.dkfz-heidelberg.de
Levitz
S
S
Harrison
T S
TS
Ruhnke
M
M
Ampel
N M
NM
Just-Nübling
G
G
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D002176:Candida albicans / Q000145:classification / Q000187:drug effects / Q000235:genetics; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology; D003045:Coccidioides / Q000145:classification / Q000187:drug effects / Q000235:genetics; D003047:Coccidioidomycosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003453:Cryptococcosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology; D003455:Cryptococcus neoformans / Q000145:classification / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008826:Microbial Sensitivity Tests