OPPORTUNISTIC INVASIVE MYCOSES IN HIV-INFECTED PATIENTS

Aim. To study the peculiarities of the clinical course of invasive mycosis in HIV-infected patients so as to improve early diagnosis and timely adequate antimycotic therapy. Materials and methods. Over the period of 2007-2014. 62 patients including 34 patients with cryptococcosis, 28 - with invasive candidosis were observed at Perm Regional Clinical Infectious Hospital. Life-time diagnosis of invasive mycosis was fixed in 55 patients, postmortem - in 7 patients on the basis of complex clinicolaboratory, instrumental and mycologic methods including isolation and identification of fungous cultures. Results. Invasive fungous infections in HIV-infected patients are characterized by severe course with affection of central nervous system, development of multisystem insufficiency and high lethality (cryptococcosis - 50 %, candidosis - 36 %). Clinical manifestations of cryptococcal meningoencephalitis and invasive candidosis are nonspecific and similar to identical diseases of other etiology. The risk factors are the following: immunodeficiency (CD4 lower than 200 kl/mkl), lack of antiretroviral therapy and presence of superficial candidosis foci. Conclusions. Thus, so as to administer a timely and adequate antimycotic therapy, diagnosis of invasive fungous infections in HIV-infected patients should be complex including clinicoinstrumental studies and obligatory mycologic analysis of blood, liquor and other biological materials.