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Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana
Introduction: Histoplasmosis is the main opportunistic infection and cause of death in HIV-infected persons living with HIV in French Guiana and probably in most of Latin America. The objective of the present study was to compare cutaneomucous histoplasmosis to non-cutaneomucous histoplasmosis in Fr...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7557946/ https://www.ncbi.nlm.nih.gov/pubmed/32806526 http://dx.doi.org/10.3390/jof6030133 |
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author | Morote, Sophie Nacher, Mathieu Blaizot, Romain Ntab, Balthazar Blanchet, Denis Drak Alsibai, Kinan Demar, Magalie Djossou, Félix Couppié, Pierre Adenis, Antoine |
author_facet | Morote, Sophie Nacher, Mathieu Blaizot, Romain Ntab, Balthazar Blanchet, Denis Drak Alsibai, Kinan Demar, Magalie Djossou, Félix Couppié, Pierre Adenis, Antoine |
author_sort | Morote, Sophie |
collection | PubMed |
description | Introduction: Histoplasmosis is the main opportunistic infection and cause of death in HIV-infected persons living with HIV in French Guiana and probably in most of Latin America. The objective of the present study was to compare cutaneomucous histoplasmosis to non-cutaneomucous histoplasmosis in French Guiana. Methods: Between 1981 and 2014 AIDS-related disseminated histoplasmosis patients followed in the three hospitals of French Guiana were retrospectively studied. Only proven incident cases of histoplasmosis, either by pathology and/or mycological analysis, were considered. Mucocutaneous histoplasmosis was ascertained by a positive mucosal or cutaneous biopsy. Results: Thirty-one patients had mucocutaneous lesions, and 318 had no mucocutaneous lesions. Patients with cutaneomucous lesions were more likely to have had prior opportunistic infections (35.5%) than those who did not have cutaneomucous lesions (19.5%). They were more likely to be very severely immunocompromised (CD4 count < 50) (90.3% versus 62.8%) and less likely to have digestive signs (32.3% versus 74.1%) and superficial adenopathies (29% versus 50.2%) than those without cutaneomucous lesions. In terms of simple biological examinations, patients with cutaneomucous lesions had fewer signs of cholestasis. The diagnosis was significantly more likely to be performed by direct examination and pathology in those with cutaneomucous lesions than in those without such lesions. On the contrary, patients with cutaneomucous lesions were less likely to be diagnosed by fungal culture than those without cutaneomucous lesions. There was a greater but non-significant risk of early death in those with cutaneomucous lesions relative to those without (OR = 2.28 (95%CI = 0.83–5.7), p = 0.056. Conclusions: Mucocutaneous forms were associated with more profound immunosuppression and perhaps risk of early death. They are easily accessible for diagnosis. |
format | Online Article Text |
id | pubmed-7557946 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-75579462020-10-22 Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana Morote, Sophie Nacher, Mathieu Blaizot, Romain Ntab, Balthazar Blanchet, Denis Drak Alsibai, Kinan Demar, Magalie Djossou, Félix Couppié, Pierre Adenis, Antoine J Fungi (Basel) Article Introduction: Histoplasmosis is the main opportunistic infection and cause of death in HIV-infected persons living with HIV in French Guiana and probably in most of Latin America. The objective of the present study was to compare cutaneomucous histoplasmosis to non-cutaneomucous histoplasmosis in French Guiana. Methods: Between 1981 and 2014 AIDS-related disseminated histoplasmosis patients followed in the three hospitals of French Guiana were retrospectively studied. Only proven incident cases of histoplasmosis, either by pathology and/or mycological analysis, were considered. Mucocutaneous histoplasmosis was ascertained by a positive mucosal or cutaneous biopsy. Results: Thirty-one patients had mucocutaneous lesions, and 318 had no mucocutaneous lesions. Patients with cutaneomucous lesions were more likely to have had prior opportunistic infections (35.5%) than those who did not have cutaneomucous lesions (19.5%). They were more likely to be very severely immunocompromised (CD4 count < 50) (90.3% versus 62.8%) and less likely to have digestive signs (32.3% versus 74.1%) and superficial adenopathies (29% versus 50.2%) than those without cutaneomucous lesions. In terms of simple biological examinations, patients with cutaneomucous lesions had fewer signs of cholestasis. The diagnosis was significantly more likely to be performed by direct examination and pathology in those with cutaneomucous lesions than in those without such lesions. On the contrary, patients with cutaneomucous lesions were less likely to be diagnosed by fungal culture than those without cutaneomucous lesions. There was a greater but non-significant risk of early death in those with cutaneomucous lesions relative to those without (OR = 2.28 (95%CI = 0.83–5.7), p = 0.056. Conclusions: Mucocutaneous forms were associated with more profound immunosuppression and perhaps risk of early death. They are easily accessible for diagnosis. MDPI 2020-08-12 /pmc/articles/PMC7557946/ /pubmed/32806526 http://dx.doi.org/10.3390/jof6030133 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Morote, Sophie Nacher, Mathieu Blaizot, Romain Ntab, Balthazar Blanchet, Denis Drak Alsibai, Kinan Demar, Magalie Djossou, Félix Couppié, Pierre Adenis, Antoine Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana |
title | Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana |
title_full | Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana |
title_fullStr | Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana |
title_full_unstemmed | Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana |
title_short | Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana |
title_sort | comparison of disseminated histoplasmosis with and without cutaneo-mucous lesions in persons living with hiv in french guiana |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7557946/ https://www.ncbi.nlm.nih.gov/pubmed/32806526 http://dx.doi.org/10.3390/jof6030133 |
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