Fungal Pathogens Associated With HIV Infection

Published: 2021-07-13 16:50:08
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The prevalence of fungal infections has increased drastically over the last decades especially among patients with HIV type 1. Fungal diseases are some of the emerging diseases and mostly infect individuals with HIV type 1 (Bouckenooghe and Shandera, 2002). Some of the most common fungal infections include candida and Cryptococcus. Other fungal infections among HIV infected patients include endemic mycoses histoplasmosis, coccidioidomycosis, penicilliosis, blastomycosis, and aspergillosis. These fungal infections have manifested themselves among HIV patients. These fungal diseases are not specifically associated with certain parts of the globe but they generally affect any HIV patient regardless of their location. However, incidences of fungal disease are lower in high-income countries because of readily available antiretroviral drugs and early testing for HIV, unlike low-income countries where there is high prevalence because patients have poor adherence to drugs, resistant to antiretroviral drugs and late screening for HIV infections. CandidiasisThis is a fungal disease is most common among HIV patients and it manifests itself in the form of mucocutaneous candidiasis. According to scientific study, at least 84 percent of HIV patients have contracted this fungal infection and 55 percent of them have developed clinical thrush. Candida pathogens infect gastrointestinal tract of adults but most infection are Sendogenously acquired. Sometimes strain of candida can be transmitted from person to person (Ampel, 1996).Candida strains which affect HIV patients appear to be the same as those that affect people without HIV. Candidiasis affects areas such as the esophagus, oropharynx, and the vagina. Oropharyngeal candidiasis is common among men while vaginal candidiasis is prevalent in women. Mucocutaneous candidiasis is treated either with topical or systemic antifungal agents although these therapies do not eliminate the infection fully. Some azole drugs such as fluconazole have failed to treat candidiasis disease such as oropharyngeal candidiasis. The failure of drugs to treat these fungal diseases is attributed to diminishing cellular immunity, drug interactions, and resistance that candida pathogens are developing against these drugs (Ampel, 1996).According to National Committee for Clinical Laboratory Standards (NCCLS), administration of antifungal agents for HIV infected patients such as fluconazole results to clinical failures and resistance by the fungi especially among patient with high immunodeficiency (Ampel, 1996). CryptococcosisThis is a rare disease which was identified before HIV epidemic and it is life-threatening among patients with AIDS. Cryptococcus neoformans is the fungi which cause the aboves infection. It has two species, neoformans and gattii which exist in a different ecological niche.It is assumed that inhalation of soil contaminated by excreta of birds’ causes’ cryptococcosis infection. Another cause of cryptococcosis neoformans is the red tree gum which is common in rural Australia. Neoformans variety causes infection which is common across the globe among HIV patients and cases associated with gattii variety have been reported to occur in tropical and subtropical regions.. Although no relationship has been established between the environmental sources of cryptococcosis neoformans and development of this fungal diseases in patients with HIV many cases of cryptococcosis in people living with HIV is usually as a result of neoformans variety because of its ubiquity in the environment makes ones easily exposed it. Suppression of the cellular immunity is linked with the development of cryptococcosis in HIV patients. This can, in turn, lead to AIDs among the infected HIV patients. The vaccination of this fungal disease involves the use of oral fluconazole as an initial therapy of cryptococcosis meningitis in HIV patients. Administration of amphotericin B and oral flucytosine has proved to be effective in faster clearance of cryptococcal in the cerebrospinal fluid.Therapy of cryptococcosis meningitis among HIV patients should start with the administration of amphotericin B with the addition of flucytosine. Fluconazole should be administered constantly as a suppressive therapy to prevent relapse (Ampel, 1996). Histoplasmosis, Blastomycosis, and CoccidioidomycosisMycoses responsible for the above infections are found in specific geographical regions. These fungi are not associated with infection such as HIV because they are endemic especially in large urban areas of the US where they are prevalent. With the spread of HIV to the Midwest of the United States, these fungi became endemic and opportunistic agents (Ampel, 1996).Histoplasma capsulatum caueses infections which occur across the globe and mostly associated with the disease in HIV patients. It is common in tropical Africa, eastern U.S and the Carribean.Coccidioidomycosis is a common infection in patients with AIDS. According to a study by Tucson in Arizona, coccidioidomycosis develops in 25 percent of patients with HIV over a period of 41 months. Immunosuppression was the major risk associated with developing this disease. According to data cases of coccidioidomycosis in patients living with HIV are transmitted between persons to persons. Most cases of this fungal disease are reported in Arizona although similar cases are in San Joaquin Valley and Northbridge, California (Bouckenooghe and Shandera, 2002).Blastomycosis is the least common and fewer cases are only reported especially in areas such as North America among people living with HIV and not more than 25 cases have been reported. Vaccines used for the treatment of this fungal infection include Amphotericin B and ketoconazole.With increased incidence of fungi as pathogens among HIV patient there been need to prevent further spread and to increase the quality of life of these people and use of oral azoles and antifungal agents have been effective.ReferencesAmpel, N. M. (1996). Emerging disease issues and fungal pathogens associated with HIV infection. Emerging infectious diseases, 2(2), 109. Bouckenooghe, A. R., & Shandera, W. X. (2002). The epidemiology of HIV and AIDS among central american, south american, and caribbean immigrants to houston, texas. Journal of Immigrant Health, 4(2), 81-86.

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