CLINICAL AND EPIDEMIOLOGICAL STUDY OF HIV CO-INFECTION AND PARACOCCIDIOIDOMYCOSIS IN A BRAZILIAN TEACHING HOSPITAL

Abstract

Introduction: Paracoccidioidomycosis (PCM) is the most prevalent systemic mycosis in Latin America. Despite this, the association with the Human Immunodeficiency Virus (HIV) is poorly described. HIV infection has been recognized as a factor that modifies the natural history of fungal diseases, among which PCM is included, with clinical particularities and greater severity being observed. Methods: The clinical, epidemiological, and evolutionary findings of PCM in 21 patients co-infected with HIV, treated at a Brazilian teaching hospital, between January 2000 and December 2023, were evaluated. Results: Of the 21 patients studied, 14 (66.7%) were men. The mean age was 37.04 years. Thirteen (61.9%) patients reported living in a rural area, current or previous, and 5 (23.8%) of them performed agricultural activities at the time of diagnosis. Thirteen (61.9%) patients were smokers and 7 (33.3%) were alcoholics. For 57.14% of the cases, PCM was the first manifestation of AIDS. The mean CD4+ T lymphocyte count was 90.8 cells/mm3. Most patients (12; 57.14%) presented concomitant manifestations of the two classic clinical forms of PCM. Amphotericin B was the most commonly used treatment, in single, combined or sequential therapy (14 patients; 66.7%). Eighteen patients (85.7%) had a good evolution with the treatment administered. Mortality was 14.3% of the cases, with 2 deaths (9.5%) attributed to PCM. Conclusions: This study corroborates the existence of particularities in HIV-PCM co-infection, with greater severity and overlapping of clinical forms, in addition to a wide differential diagnosis in our setting, requiring early diagnosis and treatment.

DOI:https://doi.org/10.56238/sevened2024.029-037