Risk factors for disseminated histoplasmosis in a cohort of HIV-infected patients in French Guiana.
Disseminated histoplasmosis is the first AIDS-defining infection in French Guiana. A retrospective cohort study studied predictive factors of disseminated histoplasmosis in HIV-infected patients between 1996 and 2008. Cox proportional hazards models were used. The variables studied were age, sex, la...
Main Authors: | , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2014-01-01
|
Series: | PLoS Neglected Tropical Diseases |
Online Access: | http://europepmc.org/articles/PMC3907336?pdf=render |
_version_ | 1811268678357876736 |
---|---|
author | Mathieu Nacher Antoine Adenis Denis Blanchet Vincent Vantilcke Magalie Demar Célia Basurko Emilie Gaubert-Maréchal Julie Dufour Christine Aznar Bernard Carme Pierre Couppié |
author_facet | Mathieu Nacher Antoine Adenis Denis Blanchet Vincent Vantilcke Magalie Demar Célia Basurko Emilie Gaubert-Maréchal Julie Dufour Christine Aznar Bernard Carme Pierre Couppié |
author_sort | Mathieu Nacher |
collection | DOAJ |
description | Disseminated histoplasmosis is the first AIDS-defining infection in French Guiana. A retrospective cohort study studied predictive factors of disseminated histoplasmosis in HIV-infected patients between 1996 and 2008. Cox proportional hazards models were used. The variables studied were age, sex, last CD4/CD8 count, CD4 nadir, herpes or pneumocystosis, cotrimoxazole and fluconazole use, antiretroviral treatment and the notion of recent initiation of HAART. A total of 1404 patients were followed for 6833 person-years. The variables independently associated with increased incidence of disseminated histoplasmosis were CD4 count<50 per mm3, CD4 count between 50 and 200 per mm3, a CD4 nadir <50 per mm3, CD8 count in the lowest quartile, herpes infection, and recent antiretroviral treatment initiation (less than 6 months). The variables associated with decreased incidence of histoplasmosis were antiretroviral treatment for more than 6 months, fluconazole treatment, and pneumocystosis. There were 13.5% of deaths at 1 month, 17.5% at 3 months, and 22.5% at 6 months after the date of diagnosis of histoplasmosis. The most important predictive factors for death within 6 months of diagnosis were CD4 counts and antiretroviral treatment. The present study did not study environmental/occupational factors but provides predictive factors for disseminated histoplasmosis and its outcome in HIV patients in an Amazonian environment during the HAART era. |
first_indexed | 2024-04-12T21:27:11Z |
format | Article |
id | doaj.art-d3d97f1d97be4bfbadf19c5b82aee823 |
institution | Directory Open Access Journal |
issn | 1935-2727 1935-2735 |
language | English |
last_indexed | 2024-04-12T21:27:11Z |
publishDate | 2014-01-01 |
publisher | Public Library of Science (PLoS) |
record_format | Article |
series | PLoS Neglected Tropical Diseases |
spelling | doaj.art-d3d97f1d97be4bfbadf19c5b82aee8232022-12-22T03:16:08ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352014-01-0181e263810.1371/journal.pntd.0002638Risk factors for disseminated histoplasmosis in a cohort of HIV-infected patients in French Guiana.Mathieu NacherAntoine AdenisDenis BlanchetVincent VantilckeMagalie DemarCélia BasurkoEmilie Gaubert-MaréchalJulie DufourChristine AznarBernard CarmePierre CouppiéDisseminated histoplasmosis is the first AIDS-defining infection in French Guiana. A retrospective cohort study studied predictive factors of disseminated histoplasmosis in HIV-infected patients between 1996 and 2008. Cox proportional hazards models were used. The variables studied were age, sex, last CD4/CD8 count, CD4 nadir, herpes or pneumocystosis, cotrimoxazole and fluconazole use, antiretroviral treatment and the notion of recent initiation of HAART. A total of 1404 patients were followed for 6833 person-years. The variables independently associated with increased incidence of disseminated histoplasmosis were CD4 count<50 per mm3, CD4 count between 50 and 200 per mm3, a CD4 nadir <50 per mm3, CD8 count in the lowest quartile, herpes infection, and recent antiretroviral treatment initiation (less than 6 months). The variables associated with decreased incidence of histoplasmosis were antiretroviral treatment for more than 6 months, fluconazole treatment, and pneumocystosis. There were 13.5% of deaths at 1 month, 17.5% at 3 months, and 22.5% at 6 months after the date of diagnosis of histoplasmosis. The most important predictive factors for death within 6 months of diagnosis were CD4 counts and antiretroviral treatment. The present study did not study environmental/occupational factors but provides predictive factors for disseminated histoplasmosis and its outcome in HIV patients in an Amazonian environment during the HAART era.http://europepmc.org/articles/PMC3907336?pdf=render |
spellingShingle | Mathieu Nacher Antoine Adenis Denis Blanchet Vincent Vantilcke Magalie Demar Célia Basurko Emilie Gaubert-Maréchal Julie Dufour Christine Aznar Bernard Carme Pierre Couppié Risk factors for disseminated histoplasmosis in a cohort of HIV-infected patients in French Guiana. PLoS Neglected Tropical Diseases |
title | Risk factors for disseminated histoplasmosis in a cohort of HIV-infected patients in French Guiana. |
title_full | Risk factors for disseminated histoplasmosis in a cohort of HIV-infected patients in French Guiana. |
title_fullStr | Risk factors for disseminated histoplasmosis in a cohort of HIV-infected patients in French Guiana. |
title_full_unstemmed | Risk factors for disseminated histoplasmosis in a cohort of HIV-infected patients in French Guiana. |
title_short | Risk factors for disseminated histoplasmosis in a cohort of HIV-infected patients in French Guiana. |
title_sort | risk factors for disseminated histoplasmosis in a cohort of hiv infected patients in french guiana |
url | http://europepmc.org/articles/PMC3907336?pdf=render |
work_keys_str_mv | AT mathieunacher riskfactorsfordisseminatedhistoplasmosisinacohortofhivinfectedpatientsinfrenchguiana AT antoineadenis riskfactorsfordisseminatedhistoplasmosisinacohortofhivinfectedpatientsinfrenchguiana AT denisblanchet riskfactorsfordisseminatedhistoplasmosisinacohortofhivinfectedpatientsinfrenchguiana AT vincentvantilcke riskfactorsfordisseminatedhistoplasmosisinacohortofhivinfectedpatientsinfrenchguiana AT magaliedemar riskfactorsfordisseminatedhistoplasmosisinacohortofhivinfectedpatientsinfrenchguiana AT celiabasurko riskfactorsfordisseminatedhistoplasmosisinacohortofhivinfectedpatientsinfrenchguiana AT emiliegaubertmarechal riskfactorsfordisseminatedhistoplasmosisinacohortofhivinfectedpatientsinfrenchguiana AT juliedufour riskfactorsfordisseminatedhistoplasmosisinacohortofhivinfectedpatientsinfrenchguiana AT christineaznar riskfactorsfordisseminatedhistoplasmosisinacohortofhivinfectedpatientsinfrenchguiana AT bernardcarme riskfactorsfordisseminatedhistoplasmosisinacohortofhivinfectedpatientsinfrenchguiana AT pierrecouppie riskfactorsfordisseminatedhistoplasmosisinacohortofhivinfectedpatientsinfrenchguiana |