       Document 0806
 DOCN  M9640806
 TI    Opportunistic coccidioidomycosis in patients infected with human
       immunodeficiency virus: prevention issues and priorities.
 DT    9604
 AU    McNeil MM; Ampel NM; Emerging Bacterial and Mycotic Diseases Branch,
       Centers for; Disease Control and Prevention, Atlanta, Georgia 30333,
       USA.
 SO    Clin Infect Dis. 1995 Aug;21 Suppl 1:S111-3. Unique Identifier :
       AIDSLINE MED/96002838
 AB    Coccidioidomycosis is an uncommon AIDS-defining illness that is endemic
       in the southwestern United States. In profoundly immunodeficient
       patients infected with human immunodeficiency virus (HIV), the disease
       is usually manifest as severe pulmonary infection and is associated with
       high mortality. Although diagnosis is often made by routine serological
       tests, these appear to be less sensitive than when used for patients who
       are not HIV-infected. New ways to diagnose the infection in HIV-infected
       patients earlier and with more certainty are urgently needed. The
       optimal antifungal regimen for active disease in HIV-infected patients
       is currently undefined, but following acute disease in severely
       immunocompromised HIV-infected patients (CD4 lymphocyte count, <
       200/microL), lifelong systemic antifungal therapy is recommended. The
       role of chemoprophylaxis for HIV-infected patients in the area of
       endemic disease is also unclear. Improvement of preventive strategies
       must await the results of well-designed future studies to determine risk
       factors, particularly environmental factors, for development of
       coccidioidomycosis and to determine the proportion of disease due to new
       vs. reactivated infection. These studies are also needed to elucidate
       the role and efficacy of different types of antifungal drug therapies
       and the specific dosages useful for prevention, treatment, and long-term
       control of these infections.
 DE    Antifungal Agents/THERAPEUTIC USE  AIDS-Related Opportunistic
       Infections/EPIDEMIOLOGY/*PREVENTION &  CONTROL
       Coccidioidomycosis/EPIDEMIOLOGY/*PREVENTION & CONTROL  *Health
       Priorities  Human  Incidence  Risk Factors  United States/EPIDEMIOLOGY
       JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

