Paracoccidioidomycosis due to Paracoccidioides brasiliensis S1 plus HIV co-infection

Memorias do Instituto Oswaldo Cruz

Almeida, Marcos de Abreu^1³  Coelho, Rowena Alves^1^1,13  Valle, Antonio Carlos Francesconi do^1^2,28  Ferreira, Ana Beatriz Teixeira Brandão Camello^1^5,55  Almeida-Paes, Rodrigo^1^8,80  Zancopé-Oliveira, Rosely Maria^1^8,89  Andrade, Hugo Boechat^1^9,93  Macedo, Priscila Marques de^1^1,12,121 

[1] Aerodyne Research Inc, Billerica, MA 01821, USA^23;Atmospheric Turbulence and Diffusion Division, ARL, National Oceanic and Atmospheric Administration, Oak Ridge, USA^66;Beilun Bureau of Meteorology, Ningbo 315800, China^3;British Geological Survey, Environmental Science Centre, Keyworth, Nottingham NG12 5GG, UK^94;Broad Institute, United States^148;Brookhaven National Laboratory, Upton, NY, USA^18;CAS Center for Excellence in Regional Atmospheric Environment, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361000, Fujian, China^29;CASP, West Building, Madingley Rise, Madingley Road, CB3 0UD, Cambridge, UK^38;Centers for Disease Control and Prevention, Atlanta, USA^108;Centro Científico Tecnológico La Plata, Buenos Aires, Argentina^160;China Center for Disease Control and Prevention, Beijing, China^110;Cold Regions Research Centre, Wilfrid Laurier University, Waterloo, Ontario, Canada^52;Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters, Nanjing University of Information Science & Technology, Nanjing 210044, China^4;College of Pharmacy, Anhui Medical University, 81 Meishan Road, Hefei 230032, China^30;Complejo Hospitalario Universitario A Coruña, La Coruña, Spain^167;Czech University of Life Sciences, Faculty of Environmental Sciences, Prague, Czech Republic^44;Delegación Territorial de AEMET (Spanish National Meteorological Agency) en Aragon, Zaragoza, Spain^75;Department of Animal Ecology & Systematics, Justus Liebig University, Heinrich-Buff-Ring 26–32 IFZ, 35392 Giessen, Germany^35;Department of Atmospheric Sciences and Department of Chemistry, Texas A&M University, College Station, TX 77843, USA^21;Department of Chemistry and Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA^9;Department of Civil and Environmental Engineering, Imperial College London, London, UK^63;Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, CA, USA^12;Department of Civil and Environmental Engineering, University of Waterloo, Waterloo, Ontario, Canada^56;Department of Earth Sciences, Western University, London, Ontario, Canada^61;Department of Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA^20;Department of Environment, Water and Natural Resources, Government of South Australia, Adelaide, SA 5000, Australia^101;Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA, USA^11;Department of Environmental Sciences, Universidade Federal de São Paulo, Diadema, São Paulo, Brazil^8;Department of Geography, University of Guelph, Guelph, Ontario, Canada^53;Department of Geography, University of Innsbruck, Innsbruck, Austria^95;Department of Geography, University of Lethbridge, Lethbridge, Alberta, Canada^55;Department of Geology, Faculty of Geology and Geophysics, University of Bucharest, Bălcescu Bd. 1, 010041 Bucharest, Romania^37;Department of Geology, University of Namur, Rue de Bruxelles 61, 5000 Namur, Belgium^93;Department of Geoscience, University of Calgary, Calgary, Alberta, Canada^57;Department of Geosciences and Engineering, Delft University of Technology, Stevinweg 1, 2628 CN Delft, the Netherlands^41;Department of Geosciences, University of Oslo, P.O. Box 1022 Blindern, 0315 Oslo, Norway^84;Department of Hydrology and Atmospheric Sciences, University of Arizona, Tucson, AZ, USA^46;Department of Renewable Resources, University of Alberta, Edmonton, Alberta, Canada^58;Department of Statistics, University of Innsbruck, Innsbruck, Austria^106;Dipartimento di Ingegneria Civile, Ambientale e Architettura, Università di Cagliari, Cagliari, Italy^80;Dipartimento di Matematica e Informatica, Università di Cagliari, Cagliari, Italy^81;Division for Biomedical Physics, Medical University of Innsbruck, Innsbruck, Austria^105;Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA^25;Duke University School of Medicine, Durham, USA^156;Duke University, Durham, USA^151;Dép. Biologie, Chimie et Géographie, groupe BOREAS and Québec-Océan, Université du Québec à Rimouski, 300 allée des ursulines, Rimouski, Qc, G5L 3A1, Canada^88;Département de Géographie and Centre d'études nordiques, Université de Montréal, Montréal, Quebec, Canada^62;ENVEO IT GmbH, Innsbruck, Austria^98;EPOC, UMR 5805, Université de Bordeaux, Allée Geoffroy Saint-Hilaire, 33615 Pessac, France^85;Environment Research Institute, Shandong University, Qingdao 266237, China^24;Environment and Climate Change Canada, Saskatoon, Canada^73;Environment and Climate Change Canada, Toronto, Canada^67;Environment and Climate Change Canada, Victoria, Canada^74;Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, WA, USA^19;Environmental and Climate Sciences Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA^6;Faculty of Physics and Electrical Engineering, University of Bremen, Bremen, Germany^50;Fundação Oswaldo Cruz, Manaus, Brasil^123;Fundação Oswaldo Cruz-Fiocruz, Belo Horizonte, Brasil^127;Fundação Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil^113;Fundação Oswaldo Cruz-Fiocruz, Salvador, Brasil^139;Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brasil^115;GET-GRGS, UMR 5563, CNRS/IRD/UPS, Observatoire Midi-Pyrénées, 31400 Toulouse, France^86;GHD Canada, Waterloo, Ontario, Canada^54;Geology and Applied Geology Unit, Faculty of Engineering, University of Mons, Place du Parc 20, 7000 Mons, Belgium^89;Georgikon Faculty, University of Pannonia, Deák Ferenc u. 16, 8360 Keszthely, Hungary^48;Grantham Institute – Climate Change and the Environment, Imperial College London, London, UK^64;Grigore Antipa National Museum of Natural History, Sos. Kiseleff Nr. 1, 011341 Bucharest, Romania^39;Groundwater and Quaternary Geology Mapping Department, Geological Survey of Denmark and Greenland, Aarhus, Denmark^82;Guangzhou Key Laboratory Environmental Catalysis and Pollution Control, Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, School of Environmental Science and Engineering, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China^22;HR Wallingford, Howbery Park, Wallingford, Oxfordshire OX10 8BA, UK^65;Harvard, Cambridge, USA^149;Hospital Geral de Nova Iguaçu, Nova Iguaçu, Brasil^126;Howard University, Washington DC, United States of America^138;Imperial College London, London, United Kingdom^150;Institut Pasteur, Paris, France^147;Institute for Soil Sciences and Agricultural Chemistry, Centre for Agricultural Research, Hungarian Academy of Sciences, Herman Ottó út 15, 1022 Budapest, Hungary^47;Institute of Atmospheric and Cryospheric Sciences, University of Innsbruck, Innsbruck, Austria^103;Institute of Hydrology and Water Resources Management, Leibniz Universität Hannover, Hannover, Germany^97;Institute of Physics, University of São Paulo, São Paulo, Brazil^14;Institute of Urban Meteorology, China Meteorological Administration, Beijing 100089, China^2;Instituto Adolfo Lutz, São Paulo, Brasil^122;Instituto Evandro Chagas, Ananindeua, Brasil^143;Instituto Mexicano del Seguro Social, Monterrey, México^164;Instituto Nacional de Medicina Tropical, Puerto Iguazú, Argentina^159;Instituto Nacional de Salud, Bogotá, Colombia^155;Instituto de Salud Carlos III, Madrid, Spain^157;Integrated Water Systems and Governance, IHE Delft, Delft, the Netherlands^76;Invited contribution by Arnaud Watlet, recipient of the EGU Hydrological Sciences Outstanding Student Poster and PICO Award 2016^91;John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA^7;Kansas Geological Survey, University of Kansas, Lawrence, KS 66047, USA^102;Karst Research Institute ZRC SAZU, Titov trg 2, 6230 Postojna, Slovenia^51;Key Lab. of Environmental Optics and Technology, Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, Hefei 230031, China^26;Key Laboratory for Aerosol-Cloud-Precipitation of China Meteorological Administration, School of Atmospheric Physics, Nanjing University of Information Science & Technology, Nanjing 210044, China^5;Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea^100;LEGOS-GRGS, UMR 5566, CNRS/IRD/UPS, Observatoire Midi-Pyrénées, 31400 Toulouse, France^87;Laboratoire de Planétologie et Géodynamique – Nantes (LPGN), UFR Sciences et Techniques, Université de Nantes, UMR-CNRS 6112, Rue de la Houssinière 2, BP92208, 44322 Nantes CEDEX 3, France^92;LuftBlick, Innsbruck, Austria^104;Mediterranean Agronomic Institute (MAIB) – Land and Water Department, Valenzano (Bari), Italy^78;Meteorological Service of Canada, Environment and Climate Change Canada, Dartmouth, Canada^71;Meteoswiss, Payerne, Switzerland^72;Ministerio de Salud, Santiago, Chile^118;NIOZ Royal Netherlands Institute for Sea Research, Department of Ocean Systems, 1790 AB Den Burg, the Netherlands^40;Nacional Colonia La Campaña, Tegucigalpa, Honduras^111;National Center For Atmospheric Research, Research Application Laboratory, Boulder, CO, USA^42;National Center for Atmospheric Research, Boulder, USA^70;National Centre for Groundwater Research and Training, School of the Environment, Flinders University, Adelaide, SA 5001, Australia^99;National Hydrology Research Centre, Saskatoon, Saskatchewan, Canada^59;National Institute of Marine Geology and Geoecology (GeoEcoMar), 23–25 Dimitrie Onciul St., 024053 Bucharest, Romania^36;Naturalis Biodiversity Center, P.O. Box 9517, 2300 RA Leiden, the Netherlands^32;Norwegian Meteorological Institute, Oslo, Norway^69;Palaeomagnetic Laboratory “Fort Hoofddijk”, Faculty of Geosciences, Utrecht University, Budapestlaan 17, 3584 CD Utrecht, the Netherlands^34;Pan American Health Organization, Washington DC, USA^112;School of Environmental Science and Optoelectronic Technology, University of Science and Technology of China, Hefei 230027, China^28;School of Mathematics and Physics, Anhui University of Technology, Ma'anshan 243032, China^31;Science Island Branch of Graduate School, University of Science and Technology of China, Hefei 230026, China^27;Secretaria de Estado da Saúde de São Paulo, São Paulo, Brasil^142;Secretaria de Estado da Saúde do Espírito Santo, Vitória, Brasil^135;Seismology-Gravimetry, Royal Observatory of Belgium, Avenue Circulaire 3, 1180 Uccle, Belgium^90;Southern Illinois University Carbondale, Carbondale, USA^120;Southern Illinois University, Carbondale, USA^119;State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China^1;State Key Laboratory of Water Resources and Hydropower Engineering Science, Wuhan University, Wuhan 430072, P.R. China^83;Superintendência de Controle de Endemias, São Paulo, Brasil^136;These authors contributed equally to this work^33;Tropical Medicine Institute Pedro Kourí, Havana, Cuba^154;UFZ-Helmholtz Centre for Environmental Research, Department of Computational Hydrosystems, Leipzig, Germany^43;Universidad Autónoma de Madrid, Madrid, Spain^166;Universidad Autónoma de Nuevo León, Monterrey, México^165;Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile^117;Universidad Nacional de Asunción, Asunción, Paraguay^162;Universidad de Chile, Santiago, Chile^116;Universidad de Pamplona, Cúcuta, Colombia^153;Universidad de la República, Montevideo, Uruguay^161;Universidad de la República, Paysandú, Uruguay^163;Universidade Estadual de Londrina, Londrina, Brasil^141;Universidade Estadual do Sudoeste da Bahia, Jequié, Brasil^132;Universidade Federal Fluminense, Niterói, Brasil^140;Universidade Federal de Minas Gerais, Belo Horizonte, Brasil^131;Universidade Federal de Pelotas, Capão do Leão, Brasil^144;Universidade Federal de Pelotas, Pelotas, Brasil^129;Universidade Federal de Sergipe, Aracaju, Brasil^137;Universidade Federal do Espírito Santo, Vitória, Brasil^134;Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brasil^125;Universidade Federal do Pará, Belém, Brasil^145;Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil^128;Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil^124;Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brasil^133;Universidade de Brasília, Brasília, Brasil^107;Universidade de São Paulo, São Paulo, Brasil^130;Universidade do Estado do Amazonas, Manaus, Brasil^114;Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil^146;University of Basilicata, School of Agricultural, Forestry and Environmental Sciences – Hydraulics and Hydrology Division, Potenza, Italy^79;University of Birmingham, Edgbaston, UK^158;University of Ghana, Legon, Ghana^109;University of Sydney, Sydney, Australia^152;Water Institute and Department of Earth and Environmental Sciences, University of Waterloo, Waterloo, Ontario, Canada^60;Water Resources Section, Delft University of Technology, Delft, the Netherlands^77;Wegener Center for Climate and Global Change, University of Graz, Graz, Austria^96;Western Kentucky University, Bowling Green, USA^121;World Meteorological Organization, Geneva, Switzerland^68;now at: Agrarian Sciences Institute, Federal University of Uberlândia, Minas Gerais, Brazil^16;now at: Coldwater Laboratory, University of Saskatchewan, Canmore, Alberta, Canada^45;now at: College of Environmental Science and Engineering, Peking University, Beijing, China^17;now at: Department of Atmospheric Sciences, University of Washington, Seattle, WA, USA^10;now at: Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, USA^13;now at: IMT Lille Douai, Université Lille, SAGE, Lille, France^15;previously published under the name Tóth^49

关键词: paracoccidioidomycosis;    Paracoccidioides brasiliensis S1;    HIV;    AIDS;    co-infection;   

DOI  :  10.1590/0074-02760170310

学科分类：地质学

来源: Bioline International

【 摘 要 】

BACKGROUND Paracoccidioidomycosis (PCM) is one of the most important systemic mycoses in Latin America and the leading fungal cause of mortality in non-immunosuppressed individuals in Brazil. However, HIV/PCM co-infection can increase the clinical severity in these co-infected patients. This co-infection is rarely reported in the literature mainly because of the different epidemiological profiles of these infections. Furthermore, PCM is a neglected and non-notifiable disease, which may underestimate the real importance of this disease. The advent of molecular studies on the species of the genus Paracoccidioides has expanded the knowledge regarding the severity and the clinical spectrum in PCM. In this context, the development of studies to describe the association of the Paracoccidioides phylogenetic cryptic species in vulnerable populations, such as HIV-infected patients, appears relevant. OBJECTIVE To describe the clinical, epidemiological, therapeutic and prognostic aspects in HIV/PCM co-infected patients, along with the molecular identification of the Paracoccidioides species involved in these cases. METHODS The investigators performed a molecular and clinical retrospective study involving HIV/PCM co-infected patients, from a reference centre for PCM care in the endemic area of Rio de Janeiro, Brazil, from 1998 to 2015. Molecular identification of the fungal strains was done by amplification of partial sequences of arf and gp43 genes. FINDINGS Of 89 patients diagnosed with PCM by fungal isolation in the culture, a viable isolate was recovered for molecular analysis from 44 patients. Of these 44 patients, 28 (63.6%) had their serum samples submitted for enzyme immunoassay tests for screening of HIV antibodies, and 5 (17.9%) had a positive result. All cases were considered severe, with a variable clinical presentation, including mixed, acute/subacute clinical forms and a high rate of complications, requiring combination therapy. Paracoccidioides brasiliensis S1 was the species identified in all cases. CONCLUSIONS HIV/PCM co-infection can change the natural history of this fungal disease. The authors reinforce the need to include HIV screening diagnostic tests routinely for patients with PCM.

【 授权许可】

Free