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Long-Term Mortality after Histoplasma Infection in People with HIV

Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
Author to whom correspondence should be addressed.
Academic Editor: George Deepe
J. Fungi 2021, 7(5), 369;
Received: 9 April 2021 / Revised: 4 May 2021 / Accepted: 6 May 2021 / Published: 8 May 2021
(This article belongs to the Special Issue Histoplasma and Histoplasmosis 2020)
Histoplasmosis is a common opportunistic infection in people with HIV (PWH); however, no study has looked at factors associated with the long-term mortality of histoplasmosis in PWH. We conducted a single-center retrospective study on the long-term mortality of PWH diagnosed with histoplasmosis between 2002 and 2017. Patients were categorized into three groups based on length of survival after diagnosis: early mortality (death < 90 days), late mortality (death ≥ 90 days), and long-term survivors. Patients diagnosed during or after 2008 were considered part of the modern antiretroviral therapy (ART) era. Insurance type (private vs. public) was a surrogate indicator of socioeconomic status. Out of 54 PWH infected with histoplasmosis, overall mortality was 37%; 14.8% early mortality and 22.2% late mortality. There was no statistically significant difference in survival based on the availability of modern ART (p = 0.60). Insurance status reached statistical significance with 38% of survivors having private insurance versus only 8% having private insurance in the late mortality group (p = 0.05). High mortality persists despite the advent of modern ART, implicating a contribution from social determinants of health, such as private insurance. Larger studies are needed to elucidate the role of these factors in the mortality of PWH. View Full-Text
Keywords: HIV; Histoplasma; antiretroviral therapy; mortality HIV; Histoplasma; antiretroviral therapy; mortality
MDPI and ACS Style

Cherabie, J.; Mazi, P.; Rauseo, A.M.; Ayres, C.; Larson, L.; Rutjanawech, S.; O’Halloran, J.; Presti, R.; Powderly, W.G.; Spec, A. Long-Term Mortality after Histoplasma Infection in People with HIV. J. Fungi 2021, 7, 369.

AMA Style

Cherabie J, Mazi P, Rauseo AM, Ayres C, Larson L, Rutjanawech S, O’Halloran J, Presti R, Powderly WG, Spec A. Long-Term Mortality after Histoplasma Infection in People with HIV. Journal of Fungi. 2021; 7(5):369.

Chicago/Turabian Style

Cherabie, Joseph, Patrick Mazi, Adriana M. Rauseo, Chapelle Ayres, Lindsey Larson, Sasinuch Rutjanawech, Jane O’Halloran, Rachel Presti, William G. Powderly, and Andrej Spec. 2021. "Long-Term Mortality after Histoplasma Infection in People with HIV" Journal of Fungi 7, no. 5: 369.

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