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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
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Academic Editor: George Deepe
J. Fungi 2021, 7(5), 369; https://doi.org/10.3390/jof7050369
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. https://doi.org/10.3390/jof7050369

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. https://doi.org/10.3390/jof7050369

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. https://doi.org/10.3390/jof7050369

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