Volume 80, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Epidemiologic and clinical data for 53 patients with paracoccidioidomycosis and co-infected with human immunodeficiency virus (HIV) (cases) were compared with those for 106 patients with endemic paracoccidioidomycosis (controls). The prevalence of co-infection was estimated in 1.4% in cases of acquired immunodeficiency syndrome (AIDS). Patients co-infected with HIV were younger, less involved in agricultural occupations; 83.7% had CD4+ cell count < 200 cells/μL. Paracoccidioidomycosis in co-infected patients usually showed a rapid progression, with more fever, frequent involvement of the lungs, and multiple extrapulmonary lesions. The response to antifungal therapy and deaths caused by paracoccidioidomycosis were similar in the two patient groups, but late relapses were more common in co-infected cases. Paracoccidioidomycosis in HIV-infected patients shows epidemiologic and clinical characteristics differing from those of the endemic disease and should be considered an AIDS-defining opportunistic infection in Latin America.


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  1. Wanke B, Londero AT, 1994. Epidemiology and paracoccidioidomycosis infection. Franco M, Lacaz CS, Restrepo-Moreno A, Del Negro G, eds. Paracoccidioidomycosis, Boca Raton, FL: CRC Press, 109–117.
  2. Mendes RP, 1994. The gamut of clinical manifestations. Franco M, Lacaz C da S, Restrepo-Moreno A, Del Negro G, eds. Paracoccidioidomycosis. Boca Raton, FL: CRC Press, 233–258.
  3. Martinez R, 2004. Paracoccidioidomicose. Sidrim JJ, Rocha MF, eds. Micologia Médica a Luz de Autores Contemporâneos. Rio de Janeiro: Guanabara-Koogan, 204–221.
  4. Shikanai-Yasuda MA, Telles Filho FQ, Mendes RP, Colombo AL, Moretti ML, 2006. Consenso em paracoccidioidomicose. Rev Soc Bras Med Trop 39 : 297–310. [Google Scholar]
  5. Goldani LZ, Martinez R, Landell GA, Machado AA, Coutinho V, 1989. Paracoccidioidomycosis in a patient with AIDS. Mycopathologia 105 : 71–74. [Google Scholar]
  6. Pedro RJ, Aoki FH, Boccato RS, Branchini ML, Gonçalves Júnior FL, Papaiordanou PM, Ramos MC, 1989. Paracoccidioidomicose e infecção pelo virus da imunodeficiência humana. Rev Inst Med Trop Sao Paulo 31 : 119–125. [Google Scholar]
  7. Bakos L, Kronfeld M, Hampe S, Castro I, Zampese M, 1989. Disseminated paracoccidioidomycosis with skin lesions in a patient with acquired immunodeficiency syndrome. J Am Acad Dermatol 20 : 854–855. [Google Scholar]
  8. Marques SA, Conterno LO, Sgarbi LP, Villagra AM, Sabongi VP, Bagatin E, Gonçalves VL, 1995. Paracoccidioidomycosis associated with acquired immunodeficiency syndrome. Report of seven cases. Rev Inst Med Trop Sao Paulo 37 : 261–265. [Google Scholar]
  9. Silva-Vergara ML, Teixeira AC, Curi VG, Costa Junior JC, Vanunce R, Carmo WM, Silva MR, 2003. Paracoccidioidomycosis associated with human immunodeficiency virus infection. Report of 10 cases. Med Mycol 41 : 259–263. [Google Scholar]
  10. Paniago AM, Freitas AC, Aguiar ES, Aguiar JI, Cunha RV, Castro AR, Wanke B, 2005. Paracoccidioidomycosis in patients with human immunodeficiency virus: review of 12 cases observed in an endemic region in Brazil. J Infect 51 : 248–252. [Google Scholar]
  11. Cimerman S, Bacha HA, Ladeira MC, 1997. Paracoccidioidomycosis in a boy infected with HIV. Mycoses 40 : 343–344. [Google Scholar]
  12. Miranda EA, Alves CA, Ferreira AV, Moreira IM, Pappalardo MC, Peluso D, Silva RJ, 1997. Bone paracoccidioidomycosis in an HIV positive patient. Braz J Infect Dis 1 : 260–265. [Google Scholar]
  13. Nogueira SA, Caimby MJ, Vasconcelos V, Halpern M, Gouveia C, Thorpe B, Ramparini C, Macieira JM, Lampert JS, 1998. Paracoccidioidomycosis and tuberculosis in AIDS patients: report of two cases in Brazil. Int J Infect Dis 2 : 168–172. [Google Scholar]
  14. Tobón AM, Orozco B, Estrada S, Jaramillo E, Bedout C, Arango M, Restrepo A, 1998. Paracoccidioidomycosis and AIDS: report of the two first Colombian cases. Rev Inst Med Trop Sao Paulo 40 : 377–381. [Google Scholar]
  15. Goldani LZ, Sugar AM, 1995. Paracoccidioidomycosis and AIDS: an overview. Clin Infect Dis 21 : 1275–1281. [Google Scholar]
  16. Karp CL, Neva FA, 1999. Tropical infectious diseases in HIV-infected patients. Clin Infect Dis 28 : 947–965. [Google Scholar]
  17. Goldani LZ, Coelho IC, Machado AA, Martinez R, 1991. Paracoccidioidomycosis and AIDS. Scand J Infect Dis 23 : 393. [Google Scholar]
  18. Castro G, Martinez R, 2006. Images in clinical medicine. Disseminated paracoccidioidomycosis and coinfection with HIV. N Engl J Med 355 : 2677. [Google Scholar]
  19. Anonymous. A vigilância epidemiológica da AIDS no Estado de São Paulo, 2007. Boletim Epidemiológico do Centro de Referência e Treinamento DST/AIDS (Centro de Vigilância Epidemiológica, Estado de São Paulo, Brazil), 16 : 4–31. [Google Scholar]
  20. Figueiredo JF, Reis VM, Machado AA, Oyama SR, Martinez R, Figueiredo LT, Fonseca BA, Costa JC, Moya MJ, Castro G, 2000. Características clínicas e epidemiológicas de pacientes da região de Ribeirão Preto, SP, Brasil, com AIDS e infecções oportunistas. Medicina (Ribeirão Preto) 33 : 141–146. [Google Scholar]
  21. Nobre V, Braga E, Rayes A, Serufo JC, Godoy P, Nunes N, Antunes CM, Lambertucci JR, 2003. Opportunistic infections in patients with AIDS admitted to a university hospital of the southeast of Brazil. Rev Inst Med Trop Sao Paulo 45 : 69–74. [Google Scholar]
  22. Santos JWA, Costa JM, Cechella M, Michel GT, Figueiredo CW, Londero AT, 1998. An unusual presentation of paracoccidioidomycosis in an AIDS patient: a case report. Mycopathologia 142 : 139–142. [Google Scholar]
  23. Benard G, Duarte AJ, 2000. Paracoccidioidomycosis: a model for evaluation of the effects of HIV on the natural history of endemic tropical diseases. Clin Infect Dis 31 : 1032–1039. [Google Scholar]
  24. Zavasc AP, Bienardt JC, Severo LC, 2004. Paracoccidioidomycosis in organ transplant recipient: case report. Rev Inst Med Trop Sao Paulo 46 : 279–281. [Google Scholar]
  25. Marques SA, Robles AM, Tortorano AM, Tuculet MA, Negroni R, Mendes RP, 2000. Mycoses associated with AIDS in the Third World. Med Mycol 38 (Suppl): 269–279. [Google Scholar]
  26. Teixeira JE, Martinez R, Câmara LM, Barbosa JE, 2001. Expression of complement receptor type 1 (CR1) on erythrocytes of paracoccidioidomycosis patients. Mycopathologia 152 : 125–133. [Google Scholar]
  27. Corti M, Villafane MF, Negroni R, Palmieri O, 2004. Disseminated paracoccidioidomycosis with peripleuritis in an AIDS patient. Rev Inst Med Trop Sao Paulo 46 : 47–50. [Google Scholar]
  28. Restrepo A, Benard G, de Castro CC, Agudelo CA, Tobón AM, 2008. Pulmonary paracoccidioidomycosis. Semin Respir Crit Care Med 29 : 182–197. [Google Scholar]
  29. Tobón AM, Agudelo CA, Rosero DS, Ochoa JE, Bedout C, Zuluaga A, Arango M, Cano LE, Sampedro J, Restrepo A, 2005. Disseminated histoplasmosis: a comparative study between patients with acquired immunodeficiency syndrome and non-human immunodeficiency virus-infected individuals. Am J Trop Med Hyg 73 : 576–582. [Google Scholar]
  30. Caseiro MM, Etzel A, Soares MC, Costa SO, 2005. Septicemia caused by Paracoccidioides brasiliensis as the cause of death of an AIDS patient from Santos, São Paulo state, Brazil-a nonendemic area. Rev Inst Med Trop Sao Paulo 47 : 209–211. [Google Scholar]
  31. Gomez BL, Figueiroa JI, Hamilton AJ, Diez S, Rojas M, Tobón AM, Hay RJ, Restrepo A, 1998. Antigenemia in patients with paracoccidioidomycosis: detection of the 87-kilodalton determinant during and after antifungal therapy. J Clin Microbiol 36 : 3309–3316. [Google Scholar]
  32. Diaz M, Negroni R, Montero-Gei F, Castro LG, Sampaio SA, Borelli D, Restrepo A, Franco L, Bran JL, Arathoon EG, Stevens DA, 1992. A Pan-American 5-year study of fluconazole therapy for deep mycosis in the immunocompetent host. Pan-American Study Group. Clin Infect Dis 14 (Suppl1): S68–S76. [Google Scholar]

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  • Received : 28 Apr 2008
  • Accepted : 28 Nov 2008

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