title: Imported acquired immunodeficiency syndrome-related histoplasmosis in metropolitan France: a comparison of pre-highly active anti-retroviral therapy and highly active anti-retroviral therapy eras.
abstract: Histoplasma capsulatum var. capsulatum infection is rare outside disease-endemic areas. Clinical presentation and outcome of acquired immunodeficiency syndrome-related histoplasmosis are unknown in non-endemic areas with wide access to highly active anti-retroviral therapy (HAART). Retrospective analysis of cases recorded at the French National Reference Center for Mycoses and Antifungals during two decades: pre-HAART (1985-1994) and HAART (1997-2006). Clinical features and outcome of all adults with proven acquired immunodeficiency syndrome-related histoplasmosis were compared between the two periods. One hundred four patients were included (40 during the pre-HAART era and 64 during the HAART era). Diagnosis was established a mean of 62 days after onset of symptoms. One-year overall mortality rates decreased from 53% (pre-HAART era) to 22% (HAART era). Diagnosis during the pre-HAART era and an older age were the only independent factors associated with death. Histoplasmosis is a rare invasive fungal infection outside disease-endemic areas. Its prognosis improved significantly during the HAART era.
authors: Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France. vincent.peigne@egp.aphp.fr
authors: Vincent
authors: V
authors: Peigne
authors: Françoise
authors: F
authors: Dromer
authors: Caroline
authors: C
authors: Elie
authors: Olivier
authors: O
authors: Lidove
authors: Olivier
authors: O
authors: Lortholary
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D005602:France / Q000453:epidemiology; D006660:Histoplasmosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D000935:Antifungal Agents