Imported Acquired Immunodeficiency Syndrome–Related Histoplasmosis in Metropolitan France: A Comparison of Pre–Highly Active Anti-Retroviral Therapy and Highly Active Anti-Retroviral Therapy Eras

Vincent Peigne Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France; Centre National de la Recherche Scientifique Unité de Raccordement des Abonnés 3012, Paris, France; Département de Biostatistiques, Hopital Necker-Enfants Malades, Paris, France; Service de Médecine Interne, Centre Hospitalier Universitaire Bichat, Paris, France; Université Paris Descartes, Hopital Necker-Enfants Malades, Centre d'Infectiologie Necker Pasteur, Paris, France

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Françoise Dromer Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France; Centre National de la Recherche Scientifique Unité de Raccordement des Abonnés 3012, Paris, France; Département de Biostatistiques, Hopital Necker-Enfants Malades, Paris, France; Service de Médecine Interne, Centre Hospitalier Universitaire Bichat, Paris, France; Université Paris Descartes, Hopital Necker-Enfants Malades, Centre d'Infectiologie Necker Pasteur, Paris, France

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Caroline Elie Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France; Centre National de la Recherche Scientifique Unité de Raccordement des Abonnés 3012, Paris, France; Département de Biostatistiques, Hopital Necker-Enfants Malades, Paris, France; Service de Médecine Interne, Centre Hospitalier Universitaire Bichat, Paris, France; Université Paris Descartes, Hopital Necker-Enfants Malades, Centre d'Infectiologie Necker Pasteur, Paris, France

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Olivier Lidove Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France; Centre National de la Recherche Scientifique Unité de Raccordement des Abonnés 3012, Paris, France; Département de Biostatistiques, Hopital Necker-Enfants Malades, Paris, France; Service de Médecine Interne, Centre Hospitalier Universitaire Bichat, Paris, France; Université Paris Descartes, Hopital Necker-Enfants Malades, Centre d'Infectiologie Necker Pasteur, Paris, France

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Olivier Lortholary and the French Mycosis Study Group Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France; Centre National de la Recherche Scientifique Unité de Raccordement des Abonnés 3012, Paris, France; Département de Biostatistiques, Hopital Necker-Enfants Malades, Paris, France; Service de Médecine Interne, Centre Hospitalier Universitaire Bichat, Paris, France; Université Paris Descartes, Hopital Necker-Enfants Malades, Centre d'Infectiologie Necker Pasteur, Paris, France

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Histoplasma capsulatum var. capsulatum infection is rare outside disease-endemic areas. Clinical presentation and outcome of acquired immunodeficiency syndrome–related histoplasmosis are unknown in non-endemic areas with wide access to highly active anti-retroviral therapy (HAART). Retrospective analysis of cases recorded at the French National Reference Center for Mycoses and Antifungals during two decades: pre-HAART (1985–1994) and HAART (1997–2006). Clinical features and outcome of all adults with proven acquired immunodeficiency syndrome–related histoplasmosis were compared between the two periods. One hundred four patients were included (40 during the pre-HAART era and 64 during the HAART era). Diagnosis was established a mean of 62 days after onset of symptoms. One-year overall mortality rates decreased from 53% (pre-HAART era) to 22% (HAART era). Diagnosis during the pre-HAART era and an older age were the only independent factors associated with death. Histoplasmosis is a rare invasive fungal infection outside disease-endemic areas. Its prognosis improved significantly during the HAART era.

Author Notes

*Address correspondence to Olivier Lortholary, Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques and Centre National de la Recherche Scientifique Unité de Raccordement des Abonnés 3012, 25–28 Rue du Docteur Roux, 75015 Paris, France. E-mail: olortho@pasteur.fr

Authors' addresses: Vincent Peigne, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques Institut Pasteur, 25–28 Rue du Docteur Roux, 75015 Paris, France (present address: Service de Réanimation Médicale, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015 Paris, France), E-mail: vincent.peigne@egp.aphp.fr. Françoise Dromer, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Centre National de la Recherche Scientifique Unité de Raccordement des Abonnés 3012, Institut Pasteur, 25–28 Rue du Docteur Roux, 75015 Paris, France, E-mail: francoise.dromer@pasteur.fr. Caroline Elie, Département de Biostatistiques, Hôpital Necker-Enfants Malades, 149 Rue de Sèvres, 75015 Paris, France, E-mail: caroline.elie@parisdescartes.fr. Olivier Lidove, Service de Médecine Interne, Centre Hospitalier Universitaire Bichat, 48 Rue Henri Huchard, 75018 Paris, France, E-mail: olivier.lidove@bch.ap-hop-paris.fr. Olivier Lortholary, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Centre Hospitalier Universitaire 3012, Institut Pasteur, 25–28 Rue du Docteur Roux, 75015 Paris, France and Université Paris Descartes, Hopital Necker-Enfants Malades, Centre d'Infectiologie Necker Pasteur, 149 Rue de Sèvres, 75015 Paris, France, E-mail: olortho@pasteur.fr.

  • 1.

    1987. Leads from the MMWR. Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. JAMA 258: 11431145, 1149, 1153–1154.

  • 2.

    Wheat LJ, 2006. Histoplasmosis: a review for clinicians from non-endemic areas. Mycoses 49: 274282.

  • 3.

    Wheat LJ, Connolly-Stringfield PA, Baker RL, Curfman MF, Eads ME, Israel KS, Norris SA, Webb DH, Zeckel ML, 1990. Disseminated histoplasmosis in the acquired immune deficiency syndrome: clinical findings, diagnosis and treatment, and review of the literature. Medicine (Baltimore) 69: 361374.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Segura L, Rojas M, Pelaez N, Shor-Posner G, RosaRe D, Moreno J, Klaskala W, Baum MK, 1997. Disseminated histoplasmosis and human immunodeficiency virus type 1 infection: risk factors in Guatemala. Clin Infect Dis 25: 343344.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Johnson PC, Wheat LJ, Cloud GA, Goldman M, Lancaster D, Bamberger DM, Powderly WG, Hafner R, Kauffman CA, Dismukes WE, 2002. Safety and efficacy of liposomal amphotericin B compared with conventional amphotericin B for induction therapy of histoplasmosis in patients with AIDS. Ann Intern Med 137: 105109.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Wheat LJ, Freifeld AG, Kleiman MB, Baddley JW, McKinsey DS, Loyd JE, Kauffman CA, 2007. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis 45: 807825.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Wheat LJ, Chetchotisakd P, Williams B, Connolly P, Shutt K, Hajjeh R, 2000. Factors associated with severe manifestations of histoplasmosis in AIDS. Clin Infect Dis 30: 877881.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    de Francesco Daher E, de Sousa Barros FA, da Silva Junior GB, Takeda CF, Mota RM, Ferreira MT, Martins JC, Oliveira SA, Gutierrez-Adrianzen OA, 2006. Risk factors for death in acquired immunodeficiency syndrome-associated disseminated histoplasmosis. Am J Trop Med Hyg 74: 600603.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Hajjeh RA, Pappas PG, Henderson H, Lancaster D, Bamberger DM, Skahan KJ, Phelan MA, Cloud G, Holloway M, Kauffman CA, Wheat LJ, 2001. Multicenter case-control study of risk factors for histoplasmosis in human immunodeficiency virus-infected persons. Clin Infect Dis 32: 12151220.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Couppie P, Sobesky M, Aznar C, Bichat S, Clyti E, Bissuel F, El Guedj M, Alvarez F, Demar M, Louvel D, Pradinaud R, Carme B, 2004. Histoplasmosis and acquired immunodeficiency syndrome: a study of prognostic factors. Clin Infect Dis 38: 134138.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Breton G, Adle-Biassette H, Therby A, Ramanoelina J, Choudat L, Bissuel F, Huerre M, Dromer F, Dupont B, Lortholary O, 2006. Immune reconstitution inflammatory syndrome in HIV-infected patients with disseminated histoplasmosis. AIDS 20: 119121.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Antinori S, Magni C, Nebuloni M, Parravicini C, Corbellino M, Sollima S, Galimberti L, Ridolfo AL, Wheat LJ, 2006. Histoplasmosis among human immunodeficiency virus-infected people in Europe: report of 4 cases and review of the literature. Medicine (Baltimore) 85: 2236.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Ashbee HR, Evans EG, Viviani MA, Dupont B, Chryssanthou E, Surmont I, Tomsikova A, Vachkov P, Enero B, Zala J, Tintelnot K, 2008. Histoplasmosis in Europe: report on an epidemiological survey from the European Confederation of Medical Mycology Working Group. Med Mycol 46: 5765.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    De Pauw B, Walsh TJ, Donnelly JP, Stevens DA, Edwards JE, Calandra T, Pappas PG, Maertens J, Lortholary O, Kauffman CA, Denning DW, Patterson TF, Maschmeyer G, Bille J, Dismukes WE, Herbrecht R, Hope WW, Kibbler CC, Kullberg BJ, Marr KA, Munoz P, Odds FC, Perfect JR, Restrepo A, Ruhnke M, Segal BH, Sobel JD, Sorrell TC, Viscoli C, Wingard JR, Zaoutis T, Bennett JE, 2008. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 46: 18131821.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    French MA, Price P, Stone SF, 2004. Immune restoration disease after antiretroviral therapy. AIDS 18: 16151627.

  • 16.

    Fine J, Gray R, 1999. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 94: 496509.

  • 17.

    De Lavaissiere M, Manceron V, Bouree P, Garcon L, Bisaro F, Delfraissy JF, Lambotte O, Goujard C, 2009. Reconstitution inflammatory syndrome related to histoplasmosis, with a hemophagocytic syndrome in HIV infection. J Infect 58: 245247.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Karimi K, Wheat LJ, Connolly P, Cloud G, Hajjeh R, Wheat E, Alves K, Lacaz Cd Cda S, Keath E, 2002. Differences in histoplasmosis in patients with acquired immunodeficiency syndrome in the United States and Brazil. J Infect Dis 186: 16551660.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Loulergue P, Bastides F, Baudouin V, Chandenier J, Mariani-Kurkdjian P, Dupont B, Viard JP, Dromer F, Lortholary O, 2007. Literature review and case histories of Histoplasma capsulatum var. duboisii infections in HIV-infected patients. Emerg Infect Dis 13: 16471652.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Baddley JW, Sankara IR, Rodriquez JM, Pappas PG, Many WJ Jr, 2008. Histoplasmosis in HIV-infected patients in a southern regional medical center: poor prognosis in the era of highly active antiretroviral therapy. Diagn Microbiol Infect Dis 62: 151156.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Lortholary O, Poizat G, Zeller V, Neuville S, Boibieux A, Alvarez M, Dellamonica P, Botterel F, Dromer F, Chene G, 2006. Long-term outcome of AIDS-associated cryptococcosis in the era of combination antiretroviral therapy. AIDS 20: 21832191.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Dheda K, Lampe FC, Johnson MA, Lipman MC, 2004. Outcome of HIV-associated tuberculosis in the era of highly active antiretroviral therapy. J Infect Dis 190: 16701676.

  • 23.

    Morris A, Wachter RM, Luce J, Turner J, Huang L, 2003. Improved survival with highly active antiretroviral therapy in HIV-infected patients with severe Pneumocystis carinii pneumonia. AIDS 17: 7380.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Ledergerber B, Egger M, Erard V, Weber R, Hirschel B, Furrer H, Battegay M, Vernazza P, Bernasconi E, Opravil M, Kaufmann D, Sudre P, Francioli P, Telenti A, 1999. AIDS-related opportunistic illnesses occurring after initiation of potent antiretroviral therapy: the Swiss HIV Cohort Study. JAMA 282: 22202226.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Lortholary O, Fontanet A, Memain N, Martin A, Sitbon K, Dromer F, 2005. Incidence and risk factors of immune reconstitution inflammatory syndrome complicating HIV-associated cryptococcosis in France. AIDS 19: 10431049.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Breton G, Duval X, Estellat C, Poaletti X, Bonnet D, Mvondo Mvondo D, Longuet P, Leport C, Vilde JL, 2004. Determinants of immune reconstitution inflammatory syndrome in HIV type 1-infected patients with tuberculosis after initiation of antiretroviral therapy. Clin Infect Dis 39: 17091712.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Nacher M, Sarazin F, El Guedj M, Vaz T, Alvarez F, Nasser V, Randrianjohany A, Aznar C, Carme B, Couppie P, 2006. Increased incidence of disseminated histoplasmosis following highly active antiretroviral therapy initiation. J Acquir Immune Defic Syndr 41: 468470.

    • PubMed
    • Search Google Scholar
    • Export Citation
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