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RISK FACTORS FOR DEATH IN ACQUIRED IMMUNODEFICIENCY SYNDROME–ASSOCIATED DISSEMINATED HISTOPLASMOSIS

ELIZABETH DE FRANCESCO DAHERDepartment of Internal Medicine, Faculdade de Medicina, Hospital Universitário Walter Cantídio, and Department of Statistics, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil; Hospital São José de Doenças Infecciosas. Fortaleza, Ceará, Brazil

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FERNANDO ANTONIO DE SOUSA BARROSDepartment of Internal Medicine, Faculdade de Medicina, Hospital Universitário Walter Cantídio, and Department of Statistics, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil; Hospital São José de Doenças Infecciosas. Fortaleza, Ceará, Brazil

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GERALDO BEZERRA DA SILVA JÚNIORDepartment of Internal Medicine, Faculdade de Medicina, Hospital Universitário Walter Cantídio, and Department of Statistics, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil; Hospital São José de Doenças Infecciosas. Fortaleza, Ceará, Brazil

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CHRISTIANNE FERNANDES VALENTE TAKEDADepartment of Internal Medicine, Faculdade de Medicina, Hospital Universitário Walter Cantídio, and Department of Statistics, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil; Hospital São José de Doenças Infecciosas. Fortaleza, Ceará, Brazil

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ROSA MARIA SALANI MOTADepartment of Internal Medicine, Faculdade de Medicina, Hospital Universitário Walter Cantídio, and Department of Statistics, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil; Hospital São José de Doenças Infecciosas. Fortaleza, Ceará, Brazil

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MARÚSIA THOMAZ FERREIRADepartment of Internal Medicine, Faculdade de Medicina, Hospital Universitário Walter Cantídio, and Department of Statistics, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil; Hospital São José de Doenças Infecciosas. Fortaleza, Ceará, Brazil

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JULIETA CUNHA MARTINSDepartment of Internal Medicine, Faculdade de Medicina, Hospital Universitário Walter Cantídio, and Department of Statistics, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil; Hospital São José de Doenças Infecciosas. Fortaleza, Ceará, Brazil

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SORAYA ALVES JACINTO OLIVEIRADepartment of Internal Medicine, Faculdade de Medicina, Hospital Universitário Walter Cantídio, and Department of Statistics, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil; Hospital São José de Doenças Infecciosas. Fortaleza, Ceará, Brazil

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OSWALDO AUGUSTO GUTIÉRREZ-ADRIANZÉNDepartment of Internal Medicine, Faculdade de Medicina, Hospital Universitário Walter Cantídio, and Department of Statistics, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil; Hospital São José de Doenças Infecciosas. Fortaleza, Ceará, Brazil

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We performed a retrospective study of 164 human immunodeficiency virus (HIV)–infected patients with disseminated histoplasmosis to identify the risk factors for death. Death occurred in 32% of the cases. Univariate analysis identified the following risk factors: diarrhea (odds ratio [OR] = 3.9, P = 0.001), neurologic manifestations (OR = 5.8, ; P = 0.001), hemoglobin level < 8.0g/dL (OR = 2.7, P = 0.004), urea level 2 times the normal upper limit (OR = 5.0, P < 0.001), creatinine level > 1.5 mg/dL (OR = 2.9, P = 0.005), aspartate aminotransferase (AST) level > 2.5 times the normal upper limit (OR = 3.1, P = 0.01), respiratory insufficiency (OR = 9.7, P < 0.001), sepsis (OR = 20.2, P < 0.001), and acute renal failure (OR = 2.5, P = 0.011). A hemoglobin level < 8.0 g/dL (OR = 3.8, P = 0.008), an AST level ≥ 2.5 times the normal limit (OR = 1.0, P = 0.007), acute renal failure (OR = 2.96, P = 0.015), and respiratory insufficiency (OR = 12.2, P = 0.01) were independent risk factors for death.

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