Journal Article

Multicenter Case-Control Study of Risk Factors for Histoplasmosis in Human Immunodeficiency Virus-Infected Persons

R. A. Hajjeh, P. G. Pappas, H. Henderson, D. Lancaster, D. M. Bamberger, K. J. Skahan, M. A. Phelan, G. Cloud, M. Holloway, C. A. Kauffman and L. J. Wheat

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 8, pages 1215-1220
Published in print April 2001 | ISSN: 1058-4838
Published online April 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/319756
Multicenter Case-Control Study of Risk Factors for Histoplasmosis in Human Immunodeficiency Virus-Infected Persons

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We conducted a multicenter case-control study to identify risk factors for histoplasmosis among persons with acquired immunodeficiency syndrome (AIDS) and to evaluate predictors of a poor outcome (defined as death or admission to the intensive care unit). Patients with histoplasmosis were each matched by age, sex, and CD4 lymphocyte count to 3 controls. From 1996 through 1999, 92 case patients and 252 controls were enrolled. Of the case patients, 81 (89%) were men, 50 (55%) were black, 78 (85%) had a CD4 lymphocyte count of <100 cells/µL, 80 (87%) were hospitalized, and 11 (12%) died. Multivariable analysis found that receipt of antiretroviral therapy and of triazole drugs were independently associated with a decreased risk of histoplasmosis. Chronic medical conditions and a history of infections with herpes simplex virus were associated with poor outcome. Triazoles should be considered for chemoprophylaxis for persons with AIDS, especially those who take part in high-risk activities that involve frequent exposure to soil, who have CD4 lymphocyte counts of <100 cells/µL, and who live in areas where histoplasmosis is endemic.

Journal Article.  3745 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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