Fungal Infections

  • Author: William G. Powderly, MD (More Info)
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 6/18/19 (What's New)

Summary

Introduction

  • Incidence of HIV-associated fungal infections has decreased significantly with the advent of effective ART[Palella 2006]
  • Certain fungal infections (eg, oropharyngeal candidiasis) remain sentinel signs of HIV infection and should prompt HIV testing in people at risk
  • In patients living with HIV, fungal infections indicate disease progression and the need to initiate or review ART

Candidiasis

    Epidemiology
    • Oropharyngeal candidiasis occurs in approximately 75% of patients with progressive HIV infection
      • Tends to be recurrent and progressively more severe with increasing immunodeficiency
    • Esophageal candidiasis occurs predominantly in patients with CD4+ cell counts < 100 cells/mm3
    • Vulvovaginal candidiasis occurs in 30% to 40% of women with HIV infection