Coccidioidomycosis among persons with human immunodeficiency virus infection in the era of highly active antiretroviral therapy (HAART)

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Abstract

Coccidioidomycosis remains an important opportunistic infection among individuals infected with human immunodeficiency virus (HIV) who live in the coccidioidal endemic area. There are several manifestations of coccidioidomycosis during HIV infection, but pulmonary disease, either diffuse or focal, is the most common. The most important factor associated with the risk for developing clinically active coccidioidomycosis is a CD4 peripheral blood lymphocyte count of less than 250/μL. The advent of highly active antiretroviral therapy (HAART) for the treatment of HIV infection has changed our approach to the management of opportunistic infections, including coccidioidomycosis. Few data are available regarding the incidence of coccidioidomycosis since the initiation of HAART, but these suggest a decline. It is currently recommended that antifungal therapy for coccidioidomycosis during HIV infection be continued indefinitely, even among those with asymptomatic disease. Future studies should indicate whether this is necessary if immune function has been reconstituted through appropriate therapy for the HIV infection.

Original languageEnglish (US)
Pages (from-to)257-262
Number of pages6
JournalSeminars in Respiratory Infections
Volume16
Issue number4
DOIs
StatePublished - 2001

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Coccidioidomycosis
Highly Active Antiretroviral Therapy
Virus Diseases
HIV
Opportunistic Infections
Asymptomatic Diseases
Lymphocyte Count
Lung Diseases
Therapeutics
Incidence

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Microbiology (medical)

Cite this

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title = "Coccidioidomycosis among persons with human immunodeficiency virus infection in the era of highly active antiretroviral therapy (HAART)",
abstract = "Coccidioidomycosis remains an important opportunistic infection among individuals infected with human immunodeficiency virus (HIV) who live in the coccidioidal endemic area. There are several manifestations of coccidioidomycosis during HIV infection, but pulmonary disease, either diffuse or focal, is the most common. The most important factor associated with the risk for developing clinically active coccidioidomycosis is a CD4 peripheral blood lymphocyte count of less than 250/μL. The advent of highly active antiretroviral therapy (HAART) for the treatment of HIV infection has changed our approach to the management of opportunistic infections, including coccidioidomycosis. Few data are available regarding the incidence of coccidioidomycosis since the initiation of HAART, but these suggest a decline. It is currently recommended that antifungal therapy for coccidioidomycosis during HIV infection be continued indefinitely, even among those with asymptomatic disease. Future studies should indicate whether this is necessary if immune function has been reconstituted through appropriate therapy for the HIV infection.",
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