Coccidioidomycosis in human immunodeficiency virus-infected persons in Arizona, 1994-1997: Incidence, risk factors, and prevention

Christopher W. Woods, Cheryl McRill, Brian D. Plikaytis, Nancy E. Rosenstein, David Mosley, Denise Boyd, Bob England, Bradley A. Perkins, Neil M. Ampel, Rana A. Hajjeh

Research output: Contribution to journalArticle

81 Scopus citations

Abstract

From 1 January 1995 through 31 June 1997, 153 cases of coccidioidomycosis in human immunodeficiency virus (HIV) infected persons were identified in Arizona (incidence, 41/1000 persons living with AIDS). A case-control study was conducted to evaluate risk factors for coccidioidomycosis in HIV-infected persons. A case was defined as laboratory- confirmed, incident coccidioidomycosis in a person infected with HIV for ≥3 months, and each case patient had 3 control patients matched by county, age group, sex, HIV/AIDS status, and CD4 lymphocyte count. Multivariable analysis identified black race and a history of oropharyngeal or esophageal candidiasis to be associated with increased risk of coccidioidomycosis; protease inhibitor therapy was associated with a reduced risk. In persons with previous history of oropharyngeal or esophageal candidiasis, having received an azole drug was associated with a reduced risk (odds ratio, 0.4; 95% confidence interval, 0.2-0.9; P = .04). Physicians may need to consider azole chemoprophylaxis for HIV-infected persons who live in areas of endemicity, have CD4 cell counts <200/μL, are black, or have a history of thrush.

Original languageEnglish (US)
Pages (from-to)1428-1434
Number of pages7
JournalJournal of Infectious Diseases
Volume181
Issue number4
DOIs
StatePublished - 2000
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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    Woods, C. W., McRill, C., Plikaytis, B. D., Rosenstein, N. E., Mosley, D., Boyd, D., England, B., Perkins, B. A., Ampel, N. M., & Hajjeh, R. A. (2000). Coccidioidomycosis in human immunodeficiency virus-infected persons in Arizona, 1994-1997: Incidence, risk factors, and prevention. Journal of Infectious Diseases, 181(4), 1428-1434. https://doi.org/10.1086/315401