Cachera Laurène, Adenis Antoine, Guarmit Basma, Rabier Sébastien, Couppié Pierre, Djossou Felix, Epelboin Loïc, Melzani Alessia, Abboud Philippe, Blanchet Denis, Demar Magalie, Alsibai Kinan Drak, Nacher Mathieu
Université Paris Descartes, Sorbonne Paris Cité, Paris 75005, France.
Centre d'Investigation Clinique, Inserm CIC 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana.
J Fungi (Basel). 2021 May 27;7(6):421. doi: 10.3390/jof7060421.
Although the burden of histoplasmosis in patients with advanced HIV has been the focus of detailed estimations, knowledge about invasive fungal infections in patients living with HIV in an Amazonian context is somewhat scattered. Our goal was thus to adopt a broader view integrating all invasive fungal infections diagnosed over a decade in French Guiana. All patients hospitalized at Cayenne hospital from 1 January 2009 to 31 December 2018 with a proven diagnosis of invasive fungal infection were included (N = 227). was the most common (48.2%), followed by Cryptococcus infection (26.3%), and pneumocystosis (12.5%). For cryptococcal infection, there was a discordance between the actual diagnosis of cryptococcal meningitis n = (26) and the isolated presence of antigen in the serum (n = 46). Among the latter when the information was available (n = 34), 21(65.6%) were treated with antifungals but not coded as cryptococcocosis. Most fungal infections were simultaneous to the discovery of HIV (38%) and were the AIDS-defining event (66%). The proportion of major invasive fungal infections appeared to remain stable over the course of the study, with a clear predominance of documented infections. Until now, the focus of attention has been histoplasmosis, but such attention should not overshadow other less-studied invasive fungal infections.
尽管晚期HIV患者组织胞浆菌病的负担一直是详细估算的重点，但在亚马逊地区，关于HIV感染者侵袭性真菌感染的了解却有些零散。因此，我们的目标是采用更广泛的视角，整合法属圭亚那十年来诊断出的所有侵袭性真菌感染情况。纳入了2009年1月1日至2018年12月31日在卡宴医院住院且确诊为侵袭性真菌感染的所有患者（N = 227）。 是最常见的（48.2%），其次是隐球菌感染（26.3%）和肺孢子菌病（12.5%）。对于隐球菌感染，隐球菌性脑膜炎的实际诊断（n = 26）与血清中单独存在抗原的情况（n = 46）之间存在不一致。在后者中，当有可用信息时（n = 34），21例（65.6%）接受了抗真菌治疗，但未编码为隐球菌病。大多数真菌感染与HIV的发现同时发生（38%），并且是定义艾滋病的事件（66%）。在研究过程中，主要侵袭性真菌感染的比例似乎保持稳定，已记录的 感染明显占主导地位。到目前为止，关注的焦点一直是组织胞浆菌病，但这种关注不应掩盖其他研究较少的侵袭性真菌感染。
