Histoplasmosis in HIV-infected patients in a southern regional medical center: poor prognosis in the era of highly active antiretroviral therapy

Academic Article

Abstract

  • Histoplasmosis is an important opportunistic infection among HIV-infected patients in endemic areas, and clinical outcomes are often poor. Additional data on factors associated with outcomes are needed to better identify patients who may require aggressive care. Using a cohort of 46 HIV-infected patients with histoplasmosis from an underserved city endemic for histoplasmosis, we explored epidemiology, outcomes, and prognostic factors. Histoplasmosis was the 1st recognized manifestation of HIV infection in 12 (26.1%) of 46 patients. Death occurred in 18 (39%) patients within 3 months of diagnosis of histoplasmosis. Fungemia (odds ratio [OR], 12.1; 95% confidence interval [CI], 1.9-76; P = 0.008), renal insufficiency (OR, 11.3; 95% CI, 1.7-77.2; P = 0.01), and age (OR, 0.9; 95% CI, 0.8-0.98; P = 0.02) were independent predictors of poor prognosis. Histoplasmosis in HIV patients is associated with poor outcomes. Identification of prognostic factors may be helpful in identifying patients who require more aggressive care.
  • Digital Object Identifier (doi)

    Author List

  • Baddley JW; Sankara IR; Rodriquez JM; Pappas PG; Many WJ
  • Start Page

  • 151
  • End Page

  • 156
  • Volume

  • 62
  • Issue

  • 2