Long-term mortality after histoplasma infection in people with HIV

Joseph Cherabie, Patrick Mazi, Adriana M. Rauseo, Chapelle Ayres, Lindsey Larson, Sasinuch Rutjanawech, Jane O’halloran, Rachel Presti, William G. Powderly, Andrej Spec

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1 Scopus citations

Abstract

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.

Original languageEnglish
Article number369
JournalJournal of Fungi
Volume7
Issue number5
DOIs
StatePublished - 2021

Keywords

  • Antiretroviral therapy
  • HIV
  • Histoplasma
  • Mortality

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