title: Aspergillosis among people infected with human immunodeficiency virus: incidence and survival. Adult and Adolescent Spectrum of HIV Disease Project.
abstract: Aspergillosis is a life-threatening fungal infection in immunocompromised people, including people infected with human immunodeficiency virus (HIV). We determined the incidence of aspergillosis among HIV-infected people and survival after aspergillosis diagnosis by use of a national HIV surveillance database. Among 35,252 HIV-infected patients, the incidence of aspergillosis was 3.5 cases per 1000 person-years (p-y; 95% confidence interval [CI], 3.0-4.0 per 1000 p-y). Incidence was higher among people aged > or =35 years (4.1 per 1000 p-y, 95% CI, 3. 5-4.8), among people with CD4 counts of 50-99 cells/mm(3) (5.1 per 1000 p-y, 95% CI, 2.8-7.3), or CD4 counts of <50 cells/mm(3) (10.2 per 1000 p-y, 95% CI, 8.0-12.2), versus people with CD4 counts of >200 cells/mm(3), people with > or =1 acquired immune deficiency syndrome-defining opportunistic illness (8.6 per 1000 p-y, 95% CI, 7.4-9.9), and people who were prescribed at least one medication associated with neutropenia (27.7 per 1000 p-y, 95% CI, 21.0-34.3). Median survival time after diagnosis of aspergillosis was 3 months, and 26% survived for > or =1 year. These findings suggest that aspergillosis is uncommon, occurs especially among severely immunosuppressed or leukopenic HIV-infected people, and is associated with poor survival.
authors.affiliation: Epidemiology Program Office, Division of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Prevention, National Center for Human Immunodeficiency Virus, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: K J
authors.initials: KJ
authors.lastname: Holding
authors.forename: M S
authors.initials: MS
authors.lastname: Dworkin
authors.forename: P C
authors.initials: PC
authors.lastname: Wan
authors.forename: D L
authors.initials: DL
authors.lastname: Hanson
authors.forename: R M
authors.initials: RM
authors.lastname: Klevens
authors.forename: J L
authors.initials: JL
authors.lastname: Jones
authors.forename: P S
authors.initials: PS
authors.lastname: Sullivan
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D000328:Adult; D000367:Age Factors; D001228:Aspergillosis / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000150:complications / Q000382:microbiology; D001230:Aspergillus / Q000302:isolation & purification; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D001234:Aspergillus niger / Q000302:isolation & purification; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications*; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology