PMID- 35704666
OWN - NLM
STAT- MEDLINE
DCOM- 20220630
LR  - 20220716
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Print)
IS  - 1935-2727 (Linking)
VI  - 16
IP  - 6
DP  - 2022 Jun
TI  - Paracoccidioidomycosis in people living with HIV/AIDS: A historical retrospective 
      cohort study in a national reference center for infectious diseases, Rio de 
      Janeiro, Brazil.
PG  - e0010529
LID - 10.1371/journal.pntd.0010529 [doi]
LID - e0010529
AB  - Paracoccidioidomycosis (PCM) is one of the main endemic systemic mycoses in Latin 
      America, usually occurring in rural areas. When PCM occurs simultaneously with 
      underlying immunosuppressive conditions, it can present as an opportunistic 
      disease. Between 2000 and 2017, literature reported around 200 PCM cases in 
      people living with HIV/AIDS (PLWHA). To address research gaps on this 
      co-infection and to study its possible temporal changes in the last decade, we 
      performed an active co-infection case search on the HIV/AIDS and PCM cohorts from 
      a Brazilian reference center database from 1989 to 2019. We found 20 PLWHA among 
      684 PCM patients (2.92%), predominantly male (70.0%) and urban workers (80.0%). 
      The median age of patients was higher in the 2010-2019 decade (p = 0.006). The 
      occurrence of PCM in PLWHA was lower when compared with other fungal diseases. 
      Although 50.0% of the patients had already been diagnosed with HIV infection and 
      presented CD4+ T cell counts greater than 200/mm3 at the time of PCM diagnosis, 
      the suspicion of immunosuppression in the context of atypical and more severe 
      clinical forms of PCM revealed the diagnosis of HIV infection in 35.0% of the 
      patients. Two (10.0%) patients had an evolution compatible with immune 
      reconstitution inflammatory syndrome (IRIS) after starting antiretroviral therapy 
      (ART).We highlight the importance of considering a PCM diagnosis in PLWHA to 
      prevent a late-onset treatment and progression to severe manifestations and 
      unfavorable outcomes. In addition, HIV investigation is recommended in PCM 
      patients, especially those with atypical and more severe clinical presentations.
FAU - Falcao, Eduardo Mastrangelo
AU  - Falcao EM
AUID- ORCID: 0000-0003-2118-653X
AD  - Clinical Research Laboratory on Infectious Dermatology, Evandro Chagas National 
      Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
FAU - de Macedo, Priscila Marques
AU  - de Macedo PM
AD  - Clinical Research Laboratory on Infectious Dermatology, Evandro Chagas National 
      Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
FAU - Freitas, Dayvison Francis Saraiva
AU  - Freitas DFS
AD  - Clinical Research Laboratory on Infectious Dermatology, Evandro Chagas National 
      Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
FAU - Freitas, Andrea d'Avila
AU  - Freitas AD
AD  - Department of Inpatient Health Care, Evandro Chagas National Institute of 
      Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
FAU - Grinsztejn, Beatriz
AU  - Grinsztejn B
AD  - Clinical Research Laboratory on HIV/AIDS, Evandro Chagas National Institute of 
      Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
FAU - Veloso, Valdilea Goncalves
AU  - Veloso VG
AD  - Clinical Research Laboratory on HIV/AIDS, Evandro Chagas National Institute of 
      Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
FAU - Almeida-Paes, Rodrigo
AU  - Almeida-Paes R
AD  - Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, 
      Fiocruz, Rio de Janeiro, Brazil.
FAU - do Valle, Antonio Carlos Francesconi
AU  - do Valle ACF
AD  - Clinical Research Laboratory on Infectious Dermatology, Evandro Chagas National 
      Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220615
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
SB  - IM
MH  - Brazil/epidemiology
MH  - Cohort Studies
MH  - *Coinfection
MH  - Female
MH  - *HIV Infections/complications/drug therapy
MH  - Humans
MH  - Male
MH  - *Paracoccidioidomycosis/complications/diagnosis/epidemiology
MH  - Retrospective Studies
PMC - PMC9239448
COIS- The authors have declared that no competing interests exist
EDAT- 2022/06/16 06:00
MHDA- 2022/07/01 06:00
PMCR- 2022/06/15
CRDT- 2022/06/15 14:23
PHST- 2022/02/16 00:00 [received]
PHST- 2022/05/20 00:00 [accepted]
PHST- 2022/06/28 00:00 [revised]
PHST- 2022/06/16 06:00 [pubmed]
PHST- 2022/07/01 06:00 [medline]
PHST- 2022/06/15 14:23 [entrez]
PHST- 2022/06/15 00:00 [pmc-release]
AID - PNTD-D-22-00221 [pii]
AID - 10.1371/journal.pntd.0010529 [doi]
PST - epublish
SO  - PLoS Negl Trop Dis. 2022 Jun 15;16(6):e0010529. doi: 
      10.1371/journal.pntd.0010529. eCollection 2022 Jun.