1. Long-Term Mortality after Histoplasma Infection in People with HIV
- Author
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Joseph Cherabie, Patrick Mazi, Adriana M. Rauseo, Chapelle Ayres, Lindsey Larson, Sasinuch Rutjanawech, Jane O’Halloran, Rachel Presti, William G. Powderly, and Andrej Spec
- Subjects
HIV ,Histoplasma ,antiretroviral therapy ,mortality ,Biology (General) ,QH301-705.5 - 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.
- Published
- 2021
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