Arguinchona H L, Ampel N M, Dols C L, Galgiani J N, Mohler M J, Fish D G
Medical Service, Veterans Affairs Medical Center, Tucson, Arizona 85723, USA.
Clin Infect Dis. 1995 May;20(5):1281-5. doi: 10.1093/clinids/20.5.1281.
We retrospectively identified 13 patients infected with human immunodeficiency virus (HIV) who had persistently positive coccidioidal serological tests without evidence of active coccidioidomycosis--to our knowledge, a heretofore undescribed phenomenon. The median duration of follow-up was 19 months. Five patients developed active coccidioidomycosis during this follow-up period; the median interval from the initial positive serological test to the development of active disease was 23 months. There were no significant differences between patients who developed active coccidioidomycosis and those who did not with regard to CD4 lymphocyte count or previous antifungal therapy. Moreover, when all 13 patients were compared with 21 patients who had HIV infection and active coccidioidomycosis, no differences were found with regard to age, race, risk factor for HIV infection, or initial CD4 lymphocyte count. In summary, persistently positive coccidioidal serological tests in HIV-infected patients appear to represent true coccidioidal infection and are associated with a significant risk of the development of active coccidioidomycosis.
我们回顾性地确定了13例感染人类免疫缺陷病毒（HIV）的患者，这些患者的球孢子菌血清学检测持续呈阳性，但无活动性球孢子菌病的证据——据我们所知，这是一种迄今未被描述的现象。随访的中位时间为19个月。在此随访期间，5例患者发生了活动性球孢子菌病；从最初血清学检测呈阳性到发生活动性疾病的中位间隔时间为23个月。发生活动性球孢子菌病的患者与未发生者在CD4淋巴细胞计数或既往抗真菌治疗方面无显著差异。此外，将所有13例患者与21例患有HIV感染和活动性球孢子菌病的患者进行比较时，在年龄、种族、HIV感染危险因素或初始CD4淋巴细胞计数方面未发现差异。总之，HIV感染患者球孢子菌血清学检测持续呈阳性似乎代表真正的球孢子菌感染，并与发生活动性球孢子菌病的显著风险相关。
