XI International Meeting on Paracoccidioidomycosis

XI International Meeting on Paracoccidioidomycosis

Resume:152-1

Poster (Painel)

152-1

PARACOCCIDIOIDAL INFECTION IN HIV PATIENTS AT AN ENDEMIC AREA OF PARACOCCIDIOIDOMYCOSIS IN BRAZIL

Authors:

Elaine Cristina Fernandes Baez-sarti (UNIDERP ANHAGUERA - Universidade Anhanguera UNIDERP) ; Sandra Maria do Valle Leone de Oliveira (UFMS - Universidade Federal de Mato Grosso do Sul) ; Zoilo Pires Camargo (UNIFESP - Universidade Federal de Sao Paulo) ; Liara Ferreira dos Santos (UFMS - Universidade Federal de Mato Grosso do Sul) ; Anamaria Mello Miranda Paniago (UFMS - Universidade Federal de Mato Grosso do Sul)

Abstract

Introduction. Paracoccidioidomycosis is caused by the thermo-dimorphic fungus Paracoccidioides brasiliensis and the endemic area is restricted to Latin America. The cellular immune response with elevation of TH1 cytokines such as gamma interferon and interleukin-2 is associated to the fungus resistance. It is plausible that paracoccidioidomycosis presents opportunistic behavior in AIDS. However, the paracoccidioidomycosis/AIDS comorbidity has been rarely observed, in contrast to other fungal diseases such as Pneumocystis jiroveci pneumonia, candidiasis, cryptococcosis and histoplasmosis. There are no studies showing the prevalence of infection with P. brasiliensis in the HIV patients and it would be important to understand the risk of endogenous reactivation in AIDS cases, especially in endemic areas of paracoccidioidomycosis Objective: To detect the prevalence of Paracoccidioides brasiliensis infection in HIV positive patients at an endemic area of paracoccidioidomycosis in Brazil. Methods: A cross-sectional study in the Day Care Hospital Profª Esterina Corsini, a medical center to HIV/AIDS patients, in the University Hospital, Mato Grosso do Sul Federal University at Campo Grande - MS. It was included patients who live in Campo Grande-MS and with a diagnosis of HIV infection (by ELISA serological method and by Western blott or indirect immunofluorescence). After clinical evaluation searching signs and symptoms of paracoccidioidomycosis, it was applied a questionnaire with epidemiological questions. It was obtained a blood sample for serology of paracoccidioidomycosis, immunodiffusion by the Ouchterlony, whose positivity is associated to paracoccidioidomycosis-disease activity. Intradermal test with glycoprotein gp43 was performed in 90 HIV/AIDS patients. A positive reaction was defined as hardened papule of 5 mm or more, after 48hs post-injection. Results: The gp43 tests were positive in 12.2%. No risk factors were associated with paracoccidiodal infection. The positive test was higher in patients with CD4 cells greater than 200, but this difference was not statistically significant. Conclusion: A prevalence of 12.2% was found and it may be even greater, considering that HIV/AIDS patients may not respond to the intradermal test, which depends on cellular immunity for its positivity. Financial support. DECIT/UNESCO/FAPESP

Keyword: Paracoccidiodes brasiliensis, AIDS, epidemiological survey, skin test, gp43

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