1887

Abstract

Sixty symptomatic confirmed human immunodeficiency virus (HIV)-positive adult patients, of both sexes, suspected of having a fungal infection were taken as a study population, and the clinicomycological profile was correlated with the immunological status of the patients with particular reference to CD4 counts. Relevant samples were collected and subjected to direct microscopy, fungal culture and serology. CD4 counts were determined by flow cytometry. Patients belonged to the age group of 17–65 years, with a male : female ratio of 4.8 : 1. Heterosexuality was the commonest mode of transmission. Candidiasis was the most common diagnosis (41.7 %), followed by cryptococcosis (10.0 %), and pneumocystinosis and aspergillosis (8.3 % each). Two cases of histoplasmosis were also diagnosed. A low mean CD4 count of <200 cells μl was seen with most fungal infections. A total of 73 % of patients belonged to World Health Organization (WHO) stage 4, while 23.33 % belonged to stage 3. Thirty one patients (51.67 %) belonged to Centers for Disease Control and Prevention (CDC) stage C3. Various fungal infections correlated well with the mean CD4 counts. It was difficult to correlate statistically WHO and CDC staging because of the small sample size. However, it was possible to assess to a limited extent the possibility of using clinical diagnosis to predict the status of progression of HIV infection in a resource-poor outpatient setting.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.46893-0
2007-08-01
2019-10-19
Loading full text...

Full text loading...

/deliver/fulltext/jmm/56/8/1101.html?itemId=/content/journal/jmm/10.1099/jmm.0.46893-0&mimeType=html&fmt=ahah

References

  1. Abouya, Y. L., Beaumel, A. & Lucas, S. ( 1992; ). Pneumocystis carinii pneumonia. An uncommon cause of death in African patients with acquired immunodeficiency syndrome. Am Rev Respir Dis 145, 617–620.[CrossRef]
    [Google Scholar]
  2. Aquinas, S. R., Tarey, S. D., Ravinderan, G. D., Nagamani, D. & Ross, C. ( 1996; ). Cryptococcal meningitis in AIDS – need for early diagnosis. J Assoc Physicians India 44, 178–180.
    [Google Scholar]
  3. Bravo, I. M., Correnti, M., Escalona, L., Perrone, M., Brito, A., Tovar, V. & Rivera, H. ( 2006; ). Prevalence of oral lesions in HIV patients related to CD4 cell count and viral load in a Venezuelan population. Med Oral Patol Oral Cir Bucal 11, E33–E39.
    [Google Scholar]
  4. CDC ( 1985; ). Revision of the case definition of acquired immune deficiency syndrome for national reporting – United States. MMWR Morb Mortal Wkly Rep 34, 373–375.
    [Google Scholar]
  5. Chariyalertsak, S., Sirisanthana, T., Saengwonloey, O. & Nelson, K. E. ( 2001; ). Clinical presentation and risk behaviours of patients with acquired immunodeficiency syndrome in Thailand, 1994–1998: regional variation and temporal trends. Clin Infect Dis 32, 955–962.[CrossRef]
    [Google Scholar]
  6. Currie, B. P. & Casadevall, A. ( 1994; ). Estimation of the prevalence of cryptococcal infection among patients infected with human immunodeficiency virus in New York City. Clin Infect Dis 19, 1029–1033.[CrossRef]
    [Google Scholar]
  7. de Repentigny, L., Lewandowski, D. & Jolicoeur, P. ( 2004; ). Immunopathogenesis of oropharyngeal candidiasis in human immunodeficiency virus infection. Clin Microbiol Rev 17, 729–759.[CrossRef]
    [Google Scholar]
  8. Forbes, B. A., Sahm, D. F. & Weissfeld, A. S. ( 2002; ). Laboratory methods in basic mycology. In Bailey and Scott's Diagnostic Microbiology, 11th edn, pp. 711–798. St Louis: Mosby.
  9. George, J., Hamida, A., Das, A. K., Amarnath, S. K. & Rao, R. S. ( 1996; ). Clinical and lab profiles of 60 patients with AIDS: a South Indian study. Southeast Asian J Trop Med Public Health 27, 686–690.
    [Google Scholar]
  10. Kaur, A., Babu, P. G., Jacob, M., Narasimhan, C., Ganesh, A., Saraswathi, N. K., Mathai, D., Pulimood, B. M. & John, T. J. ( 1992; ). Clinical and laboratory profile in AIDS in India. J Acquir Immune Defic Syndr 5, 883–889.
    [Google Scholar]
  11. Koneman, E. W., Allen, S. D., Janda, W. M. & Schreckenberger, P. C. ( 1997; ). Mycology. In Color Atlas and Textbook of Diagnostic Microbiology, 5th edn., pp 983–1057. Philadelphia, PA: Lippincott Williams & Wilkins.
  12. Kothari, K. & Goyal, S. ( 2001; ). Clinical profile of AIDS. J Assoc Physicians India 49, 435–438.
    [Google Scholar]
  13. Kumarasamy, N., Solomon, S., Paul, S. A. J., Venilla, R. & Amalraj, R. E. ( 1995; ). Spectrum of opportunistic infections among AIDS patients in Tamil Nadu, India. Int J STD AIDS 6, 447–449.
    [Google Scholar]
  14. Lattif, A. A., Banerjee, U., Prasad, R., Biswas, A., Wig, N., Sharma, N., Haque, A., Gupta, N., Baquer, N. Z. & Mukhopadhyay, G. ( 2004; ). Susceptibility pattern and molecular type of species-specific Candida in oropharyngeal lesions of Indian human immunodeficiency virus-positive patients. J Clin Microbiol 42, 1260–1262.[CrossRef]
    [Google Scholar]
  15. Maenza, J. R., Keruly, J. C., Moore, R. D., Chaisson, R. E., Merz, W. G. & Gallant, J. E. ( 1996; ). Risk factors for fluconazole-resistant candidiasis in human immuno-deficiency virus-infected patients. J Infect Dis 173, 219–225.[CrossRef]
    [Google Scholar]
  16. Martinez, M., López-Ribot, J. L., Kirkpatrick, W. R., Coco, B. J., Bachmann, S. P. & Patterson, T. F. ( 2002; ). Replacement of Candida albicans with C. dubliniensis in human immunodeficiency virus-infected patients with oropharyngeal candidiasis treated with fluconazole. J Clin Microbiol 40, 3135–3139.[CrossRef]
    [Google Scholar]
  17. Milne, L. J. R. ( 1996; ). Fungi. In Mackie and McCartney Practical Medical Microbiology, 14th edn, pp 695–720. New York: Churchill Livingstone.
  18. Mirdha, B. R., Banerjee, U., Sethi, S., Samantry, J. C. & Malaviya, A. N. ( 1993; ). Spectrum of opportunistic fungal and parasitic infections in hospitalized AIDS patients. CARC Calling 6, 9–10.
    [Google Scholar]
  19. Moore, G. S. & Jaciow, D. M. ( 1979; ). Mycology for the Clinical Laboratory. Reston, VA: Prentice-Hall.
  20. NACO ( 1999; ). Spectrum of opportunistic infections in AIDS in India. In Specialists Training and Reference Module, chapter 11, pp. 99–103 (http://www.nacoonline.org/publication/9.pdf). New Delhi: National AIDS Control Organisation.
  21. Nissapatorn, V., Lee, C., Fatt, Q. K. & Abdullah, K. A. ( 2003; ). AIDS-related opportunistic infections in hospital Kuala Lumpur. Jpn J Infect Dis 56, 187–192.
    [Google Scholar]
  22. Phillips, P., Zemcov, J., Mahmood, W., Montaner, J. S., Craib, K. & Clarke, A. M. ( 1996; ). Itraconazole cyclodextrin solution for fluconazole-refractory oropharyngeal candidiasis in AIDS: correlation of clinical response with in vitro susceptibility. AIDS 10, 1369–1376.[CrossRef]
    [Google Scholar]
  23. Rosen, M. J. ( 1994; ). Pneumonia in patients with HIV infection. Med Clin North Am 78, 1067–1078.
    [Google Scholar]
  24. Sivaraman, V., Gilbert, F. & Rao, R. S. ( 1992; ). HIV infection and pulmonary tuberculosis: report of 6 cases. Indian J Tuberc 39, 35–39.
    [Google Scholar]
  25. Udwadia, Z. F., Doshi, A. V. & Bhaduri, A. S. ( 2005; ). Pneumocystis carinii pneumonia in HIV infected patients from Mumbai. J Assoc Physicians India 53, 437–440.
    [Google Scholar]
  26. UNAIDS/WHO ( 2005; ). AIDS Epidemic Update: December 2005. Geneva: UNAIDS and WHO.
  27. Vajpayee, M., Kanswal, S., Seth, P. & Wig, N. ( 2003; ). Spectrum of opportunistic infections and profile of CD4+ counts among AIDS patients in north India. Infection 31, 336–340.
    [Google Scholar]
  28. White, D. A. & Zaman, K. M. ( 1992; ). Medical management of AIDS patients. Med Clin North Am 76, 19–44.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.46893-0
Loading
/content/journal/jmm/10.1099/jmm.0.46893-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error