PMID- 30921453
OWN - NLM
STAT- MEDLINE
DCOM- 20210106
LR  - 20210106
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 70
IP  - 4
DP  - 2020 Feb 3
TI  - Incidence and Trends in Immune Reconstitution Inflammatory Syndrome Associated 
      With Histoplasma capsulatum Among People Living With Human Immunodeficiency 
      Virus: A 20-Year Case Series and Literature Review.
PG  - 643-652
LID - 10.1093/cid/ciz247 [doi]
AB  - BACKGROUND: Histoplasmosis is among the main acquired immunodeficiency syndrome 
      (AIDS)-defining conditions in endemic areas. Although histoplasmosis has a 
      worldwide distribution, histoplasmosis-associated immune reconstitution 
      inflammatory syndrome (IRIS) in people living with human immunodeficiency virus 
      (PLHIV) is rarely reported.This study aimed to describe the incidence and 
      features of histoplasmosis-associated IRIS in a cohort of PLHIV. METHODS: A 
      retrospective multicenter study was conducted in French Guiana from 1 January 
      1997 to 30 September 2017. The target population was represented by PLHIV who 
      presented an episode of histoplasmosis within 6 months after antiretroviral 
      therapy initiation. We used a consensual IRIS case definition, submitted to the 
      agreement of 2 experts. Each case was described using a standardized 
      questionnaire, and all patients gave informed consent. RESULTS: Twenty-two cases 
      of histoplasmosis-associated IRIS were included (14 infectious/unmasking and 8 
      paradoxical), with an overall incidence rate of 0.74 cases per 1000 HIV-infected 
      person-years (95% confidence interval, 0.43-1.05). Mean age was 40.5 years. The 
      ratio of males to females was 1:4. Median time to IRIS was 11 days (interquartile 
      range 7-40 days) after antiretroviral therapy initiation. The main clinical 
      presentation was fever, without any specific pattern, and disseminated disease. 
      We reported 2 severe cases and partial or complete recovery at 1 month was the 
      rule. Twenty-two cases were identified in the literature with similar 
      characteristics. CONCLUSIONS: Histoplasmosis-associated IRIS incidence was low 
      but generated significant morbidity in PLHIV. In endemic areas, screening for 
      latent or subclinical histoplasmosis should be implemented before antiretroviral 
      therapy initiation.
CI  - (c) The Author(s) 2019. Published by Oxford University Press for the Infectious 
      Diseases Society of America. All rights reserved. For permissions, e-mail: 
      journals.permissions@oup.com.
FAU - Melzani, Alessia
AU  - Melzani A
AD  - Unite de Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne.
AD  - Equipe EA3593, Ecosystemes Amazoniens et Pathologie Tropicale, Universite de 
      Guyane, Cayenne.
FAU - de Reynal de Saint Michel, Regis
AU  - de Reynal de Saint Michel R
AD  - Service de Dermatologie-Venerologie, Centre Hospitalier de Cayenne.
FAU - Ntab, Balthazar
AU  - Ntab B
AD  - Departement d'Information Medicale, Centre Hospitalier de l'Ouest Guyanais, Saint 
      Laurent du Maroni.
FAU - Djossou, Felix
AU  - Djossou F
AD  - Unite de Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne.
AD  - Equipe EA3593, Ecosystemes Amazoniens et Pathologie Tropicale, Universite de 
      Guyane, Cayenne.
FAU - Epelboin, Loic
AU  - Epelboin L
AD  - Unite de Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne.
AD  - Equipe EA3593, Ecosystemes Amazoniens et Pathologie Tropicale, Universite de 
      Guyane, Cayenne.
FAU - Nacher, Mathieu
AU  - Nacher M
AD  - Equipe EA3593, Ecosystemes Amazoniens et Pathologie Tropicale, Universite de 
      Guyane, Cayenne.
AD  - Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, Centre 
      Hospitalier de Cayenne.
FAU - Blanchet, Denis
AU  - Blanchet D
AD  - Equipe EA3593, Ecosystemes Amazoniens et Pathologie Tropicale, Universite de 
      Guyane, Cayenne.
AD  - Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Centre 
      Hospitalier de Cayenne, France.
FAU - Demar, Magalie
AU  - Demar M
AD  - Equipe EA3593, Ecosystemes Amazoniens et Pathologie Tropicale, Universite de 
      Guyane, Cayenne.
AD  - Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Centre 
      Hospitalier de Cayenne, France.
FAU - Couppie, Pierre
AU  - Couppie P
AD  - Equipe EA3593, Ecosystemes Amazoniens et Pathologie Tropicale, Universite de 
      Guyane, Cayenne.
AD  - Service de Dermatologie-Venerologie, Centre Hospitalier de Cayenne.
FAU - Adenis, Antoine
AU  - Adenis A
AD  - Equipe EA3593, Ecosystemes Amazoniens et Pathologie Tropicale, Universite de 
      Guyane, Cayenne.
AD  - Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, Centre 
      Hospitalier de Cayenne.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
SB  - IM
MH  - *AIDS-Related Opportunistic Infections
MH  - Adult
MH  - Female
MH  - French Guiana
MH  - HIV
MH  - *HIV Infections/complications/drug therapy/epidemiology
MH  - Histoplasma
MH  - *Histoplasmosis/epidemiology
MH  - Humans
MH  - *Immune Reconstitution Inflammatory Syndrome/epidemiology
MH  - Incidence
MH  - Male
MH  - Retrospective Studies
OTO - NOTNLM
OT  - French Guiana
OT  - HIV
OT  - histoplasmosis
OT  - immune reconstitution inflammatory syndrome
OT  - incidence
EDAT- 2019/03/29 06:00
MHDA- 2021/01/07 06:00
CRDT- 2019/03/29 06:00
PHST- 2018/11/02 00:00 [received]
PHST- 2019/03/21 00:00 [accepted]
PHST- 2019/03/29 06:00 [pubmed]
PHST- 2021/01/07 06:00 [medline]
PHST- 2019/03/29 06:00 [entrez]
AID - 5421706 [pii]
AID - 10.1093/cid/ciz247 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2020 Feb 3;70(4):643-652. doi: 10.1093/cid/ciz247.