Epidemiology and clinical manifestations of pulmonary aspergillosis and invasive disease in HIV-infected patients
- John W Baddley, MD, MSPH
John W Baddley, MD, MSPH
- Professor of Medicine
- Birmingham VA Medical Center
- University of Alabama at Birmingham
Aspergillosis refers to the illness caused by a species of the fungus, Aspergillus. A broad range of manifestations can be seen in Aspergillus infection, including allergic disease, semi-invasive, and invasive disease. Although Aspergillus species are ubiquitous in nature, infection is uncommon, except in immunocompromised or immunosuppressed hosts. Patients with acquired immunodeficiency syndrome (AIDS) are susceptible to Aspergillus infection, which can lead to disseminated disease with high rates of morbidity and mortality .
This topic will review the epidemiology, pathogenesis and clinical manifestations of invasive aspergillosis in patients with AIDS. The diagnosis and treatment of aspergillosis is discussed elsewhere. (See "Diagnosis and treatment of invasive pulmonary aspergillosis in HIV-infected patients".)
In the years prior to the introduction of potent antiretroviral therapy (ART), invasive aspergillosis was an important cause of morbidity and mortality in patients with AIDS. In the present day, this infection is now rarely seen except among untreated patients with advanced immunosuppression.
Incidence — Invasive aspergillosis (IA) is an uncommon, although life-threatening, infection in patients with AIDS . Surveys from the United States demonstrate that since the introduction of potent antiretroviral therapy (ART) in 1996, the incidence of aspergillosis is low:
●In a study of 35,252 HIV-infected patients in a national database, the incidence of aspergillosis was 3.5 cases per 1000 person-years .
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- Risk factors
- PATHOGENESIS AND PATHOLOGY
- CLINICAL PRESENTATION
- LABORATORY ABNORMALITIES
- RADIOGRAPHIC MANIFESTATIONS
- OTHER FORMS OF PULMONARY DISEASE
- Tracheobronchial disease
- Allergic bronchopulmonary aspergillosis
- SUMMARY AND RECOMMENDATIONS