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Coccidioidomycosis in Persons Infected with HIV‐1
Author(s) -
AMPEL NEIL M.
Publication year - 2007
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1406.033
Subject(s) - medicine , fluconazole , pneumonia , pneumocystis pneumonia , opportunistic infection , immunology , cryptococcosis , serology , itraconazole , amphotericin b , human immunodeficiency virus (hiv) , aids related opportunistic infections , dermatology , antifungal , viral disease , sida , pneumocystis jirovecii , antibody
: Coccidioidomycosis is a recognized opportunistic infection in those with HIV‐1 infection. The major risk factor is immunodeficiency, particularly when the peripheral blood CD4 T lymphocyte count is below 250/μL. There are many manifestations of coccidioidomycosis during HIV‐1 infection, including diffuse, reticulonodular pneumonia, focal primary pneumonia, and disease disseminated beyond the thoracic cavity. Diagnosis is based on serology, culture and histopathologic identification. Two therapeutic modalities are currently available, the polyene antifungal amphotericin B and the triazole antifungals. Of the latter, the most experience is with the triazoles fluconazole and itraconazole. There are increasing data regarding drug interactions between triazoles and antiretroviral agents. The duration of treatment of coccidioidomycosis in those with HIV‐1 infection is not established and in many patients it is either prolonged or life‐long. Adherence to antiretroviral therapy is important in preventing recurrence.