Disseminated Histoplasmosis in Persons Living with HIV, France and Overseas Territories,1992–2021
Disseminated histoplasmosis is a major issue among persons with advanced HIV in the Americas; it might also affect persons in sub-Saharan Africa, the Caribbean, and Asia and can be mistaken for other infections. By using 1992-2021 data from the French hospital database on HIV, we analyzed 198,798 pe...
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| Published in: | Emerging infectious diseases Vol. 31; no. 7; pp. 1377 - 1385 |
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| Main Authors: | , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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United States
U.S. National Center for Infectious Diseases
01.07.2025
Centers for Disease Control and Prevention |
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| ISSN: | 1080-6040, 1080-6059, 1080-6059 |
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| Abstract | Disseminated histoplasmosis is a major issue among persons with advanced HIV in the Americas; it might also affect persons in sub-Saharan Africa, the Caribbean, and Asia and can be mistaken for other infections. By using 1992-2021 data from the French hospital database on HIV, we analyzed 198,798 persons with HIV follow-up in France and its overseas territories, identifying 553 (2.8/1,000 person-years) first episodes of disseminated histoplasmosis. Incidence rates varied by site of follow-up: 9.41 in French Guiana, 0.76 in Guadeloupe, 0.62 in Martinique, and 0.079 in mainland France. Incidence rates in France also varied between regions of origin or travel: 4.73 for Central or South America, 1.36 for the Caribbean, and 0.19 for sub-Saharan Africa or Asia. Differences persisted after adjusting for age, sex, CD4 count, and viral load at baseline. Overall, incidence and early death have declined, likely because of antiretroviral drug rollout in France. |
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| AbstractList | Disseminated histoplasmosis is a major issue among persons with advanced HIV in the Americas; it might also affect persons in sub-Saharan Africa, the Caribbean, and Asia and can be mistaken for other infections. By using 1992–2021 data from the French hospital database on HIV, we analyzed 198,798 persons with HIV follow-up in France and its overseas territories, identifying 553 (2.8/1,000 person-years) first episodes of disseminated histoplasmosis. Incidence rates varied by site of follow-up: 9.41 in French Guiana, 0.76 in Guadeloupe, 0.62 in Martinique, and 0.079 in mainland France. Incidence rates in France also varied between regions of origin or travel: 4.73 for Central or South America, 1.36 for the Caribbean, and 0.19 for sub-Saharan Africa or Asia. Differences persisted after adjusting for age, sex, CD4 count, and viral load at baseline. Overall, incidence and early death have declined, likely because of antiretroviral drug rollout in France. Disseminated histoplasmosis is a major issue among persons with advanced HIV in the Americas; it might also affect persons in sub-Saharan Africa, the Caribbean, and Asia and can be mistaken for other infections. By using 1992-2021 data from the French hospital database on HIV, we analyzed 198,798 persons with HIV follow-up in France and its overseas territories, identifying 553 (2.8/1,000 person-years) first episodes of disseminated histoplasmosis. Incidence rates varied by site of follow-up: 9.41 in French Guiana, 0.76 in Guadeloupe, 0.62 in Martinique, and 0.079 in mainland France. Incidence rates in France also varied between regions of origin or travel: 4.73 for Central or South America, 1.36 for the Caribbean, and 0.19 for sub-Saharan Africa or Asia. Differences persisted after adjusting for age, sex, CD4 count, and viral load at baseline. Overall, incidence and early death have declined, likely because of antiretroviral drug rollout in France.Disseminated histoplasmosis is a major issue among persons with advanced HIV in the Americas; it might also affect persons in sub-Saharan Africa, the Caribbean, and Asia and can be mistaken for other infections. By using 1992-2021 data from the French hospital database on HIV, we analyzed 198,798 persons with HIV follow-up in France and its overseas territories, identifying 553 (2.8/1,000 person-years) first episodes of disseminated histoplasmosis. Incidence rates varied by site of follow-up: 9.41 in French Guiana, 0.76 in Guadeloupe, 0.62 in Martinique, and 0.079 in mainland France. Incidence rates in France also varied between regions of origin or travel: 4.73 for Central or South America, 1.36 for the Caribbean, and 0.19 for sub-Saharan Africa or Asia. Differences persisted after adjusting for age, sex, CD4 count, and viral load at baseline. Overall, incidence and early death have declined, likely because of antiretroviral drug rollout in France. |
| Audience | Professional Academic |
| Author | Sellier, Pierre Bani-Sadr, Firouze Peugny, Sandrine Couppié, Pierre Françoise, Ugo Ouedraogo, Elise Vignier, Nicolas Grabar, Sophie Nacher, Mathieu Denis, Blandine Gallien, Sebastien Adenis, Antoine Meybeck, Agnes Marshall, Esaïe |
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| Keywords | Americas fungal infection Asia HIV/AIDS and other retroviruses fungi Africa Histoplasma spp histoplasmosis Caribbean France incidence global burden |
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| SubjectTerms | Acquired immune deficiency syndrome Adult AIDS AIDS-Related Opportunistic Infections - epidemiology AIDS-Related Opportunistic Infections - history Analysis Antiretroviral agents Data warehouses Disease Diseases Disseminated Histoplasmosis in Persons Living with HIV, France and Overseas Territories,1992–2021 Female France - epidemiology French Guiana - epidemiology fungal infection fungi Health aspects Highly active antiretroviral therapy Histoplasma spp Histoplasmosis Histoplasmosis - epidemiology Histoplasmosis - history History, 21st Century HIV HIV (Viruses) HIV Infections - complications HIV Infections - epidemiology HIV patients HIV/AIDS and other retroviruses Human immunodeficiency virus Humans Incidence Infection Male Martinique - epidemiology Medical prognosis Middle Aged Risk factors Sexually transmitted diseases Statistics STD |
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