The spectrum of opportunistic fungal infections in relation with ART in HIV patients

Recent years have witnessed a phenomenal increase in prevalence as well as severity of opportunistic fungal infection (OFIs) despite of availability of different therapeutic options. This could be attributed to various reasons including increased prevalence of immunocomprised patients. Awareness of spectrum of fungal infections in immunocompromised conditions and their epidemiological changes is critical for early diagnosis and proper management. Method: A total of 277 clinical samples were collected from 216 HIV patients suspected of OFI. Sample processing and identification of fungi carried out by standard conventional methods. Result: Out of 216 patients, 30% (65) showed positive fungal etiology with single or multiple system involvement. Oral candidiasis ranked highest (46%) followed by Cryptococcal meningitis (35%), Candidial pneumonia (10%), Oesophageal candidiasis (7%), Dermatophytoses (6%), Pulmonary aspergillosis (4%), Systemic candidiasis (4%), Pneumocystis pneumonia (3%) etc. Discussion: As most of opportunistic fungi (OF) are part of the normal human microbial flora, clinical significance of fungal isolates must be confirmed by standard criteria laid down such as repeated isolation, supportive clinical findings and radiographical evidences. Although Antiretroviral Therapy for minimum 6 months duration provides protection against OFI by maintaining CD4 count, compliance to treatment important.