Sporotrichosis is a worldwide-distributed mycosis caused by species of the Sporotrhrix complex. It is also recognized as a major opportunistic disease for HIV population in regions where both epidemics overlap. Thus, we aim to evaluate the risk factors potentially associated with death among co-infected patients.
Three databases (all from 1984-2015) were searched for publication reporting infection by sporotrichosis in HIV subjects. The search strategy was based on a combination of the keywords "Sportrichosis" AND "HIV"OR "AIDS". All references were also reviewed. An analytical database was created. Logistic regression models were used to assess the independent predictors of mortality. A two-sided p value <0.05 was considered significant. SPSS version 22 was used for analyze.
A total of 61 patients with HIV/Sporotrichosis were identified. An increase in the number of reports over time was noted, with 47.5% cases from 2010-2015 (Figure). Thirty-six (60%) were from Brazil. Mortality was 29%. Survivors presented with higher CD4+ counts compared to non-survivors (92 vs 58 cells/mm3, p<0.01). Sporothrix meningitis was found in 2.5% and 56.3% of survivors and non-survivors, respectively (p<0.0001). Mortality improved from 46% in the 1990s to 12% in the 2010s. Meningitis and use of Amphotericin B (AmB) predicted death (OR 76.95; CI 95% 5.98-9.89,p<0.001; OR 0.044; CI 95% 0.002-0.913, p<0.043, respectively).
We found that the presence of meningitis negatively impacts the overall survival whereas the use of AmB was associated with improved outcomes. In addition, clinicians dealing with both entities need to be aware of the risk of severe sportrichosis in HIV-infected patients.
Number of HIV-associated sporotrichosis cases reported over a period of 4 decades.
C. Lamas, None