Abstract:Human immunodeficiency virus (HIV) infection is a risk factor for invasive fungal infections (IFIs). IFI remains one of the major opportunistic infections and a leading cause of infection-related mortality in HIV/acquired immunodeficiency syndrome (AIDS) patients in spite of the widespread use of highly active antiretroviral therapy (HAART). The most common IFIs include mucocutaneous candidiasis, pneumocystis pneumonia, cryptococcal meningitis, and penicilliosis marneffei. Compared with non-HIV infection patients, the diagnosis of IFI in HIV patients is more complex and special. Diagnosis should be made through the combined analysis of the immune status of the patients, clinical manifestations, imaging examinations and mycological laboratory test results. The diagnostic methodology for IFI in non-HIV patients should not be simply applied in HIV patients, and the sensitivity and specificity of some diagnostic techniques should be re-evaluted in HIV patients. Antifungal therapy and HAART are the two essential aspects of the treatment of HIV coinfection with IFIs. Careful attention should be paid to drug interactions between antifungal agents and HAART. HIV patients who have completed the initial antifungal therapy should be administered chronic maintenance therapy with antifungal drugs according to CD4 cell counts, drug-drug interactions and side effects. HIV patients are highly vulnerable to IFIs, and chemoprophylaxis for high-risk patients with severe immunosuppression should be initiated to decrease the incidence of special IFIs in HIV patients. Early diagnosis and optimized treatment for IFIs in HIV patients need to be further studied and explored.
沈银忠,卢洪洲 . 艾滋病合并侵袭性真菌感染的诊治[J]. 微生物与感染, 2015, 10(5): 275-281.
SHEN Yin-Zhong, LU Hong-Zhou. Diagnosis and treatment for invasive fungal infections in human immunodeficiency virus-infected patients. JOURNAL OF MICROBES AND INFECTIONS, 2015, 10(5): 275-281.