Frequency of fungal pathogens in autopsy studies of people who died with HIV in Africa: a scoping review.

Autor:	Bongomin F; Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda; Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom. Electronic address: drbongomin@gmail.com., Kibone W; Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda; Department of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda., Atulinda L; Department of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda., Morgan B; Trust Library Services, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom., Ocansey B; Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom., Storer ISR; Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom., van Rhijn N; Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom., Muzoora C; Department of Internal Medicine, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda., Denning DW; Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom., Hamer DH; Department of Global Health, Boston University School of Public Health, Boston, MA, USA; Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA; National Emerging Infectious Disease Laboratory, Boston, MA, USA; Center for Emerging Infectious Diseases Policy & Research, Boston University, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2024 May; Vol. 30 (5), pp. 592-600. Date of Electronic Publication: 2023 Dec 23.
DOI:	10.1016/j.cmi.2023.12.016
Abstrakt:	Background: Fungal infections are common in HIV-infected individuals and significantly contribute to mortality. However, a substantial number of cases are undiagnosed before death. Objective: To determine the frequency of fungal pathogens in autopsy studies of people who died with HIV in Africa. Methods: We conducted a scoping review of autopsy studies conducted in Africa. Data Sources: PubMed, Scopus, Web of Science, Embase, Google Scholar, and African Journal Online. Study Eligibility Criteria: The review encompasses studies published from inception to September 2023, and no language restrictions were imposed during the search process. We included studies that reported histopathological or microbiological evidence for the diagnosis of fungal infections and other pathogens. Data Synthesis: Data were summarized using descriptive statistics and no meta-analysis was performed. Results: We examined 30 articles reporting studies conducted between 1991 and 2019, encompassing a total of 13 066 HIV-infected decedents across ten African countries. In five studies, the autopsy type was not specified. Among those studies with specified autopsy types, 20 involved complete diagnostic autopsies, whereas 5 were categorized as partial or minimally invasive autopsies. There were 2333 pathogens identified, with 946 (40.5%) being mycobacteria, 856 (36.7%) fungal, 231 (3.8%) viral, 208 (8.9%) parasitic, and 92 (3.9%) bacterial. Of the 856 fungal pathogens identified, 654 (28.0%) were Cryptococcus species, 167 (7.2%) Pneumocystis jirovecii, 16 (0.69%) Histoplasma species, 15 (0.64%) Aspergillus species, and 4 (0.17%) Candida species. Other major non-fungal pathogens identified were cytomegalovirus 172 (7.37%) and Toxoplasma gondii 173 (7.42%). Conclusions: Invasive fungal infections occur in over one-third of people who succumb to HIV in Africa. In addition to cryptococcosis and Pneumocystis jirovecii pneumonia, integrating other priority fungal pathogen detection and management strategies into the broader framework of HIV care in Africa is recommended. This involves increasing awareness regarding the impact of fungal infections in advanced HIV disease and strengthening diagnostic and treatment capacity. (Copyright © 2023 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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