Changing epidemiology of invasive fungal infections : focus on HIV/AIDS patients

The epidemiology of invasive fungal infections (IFI) in HIV/AIDS patients has changed profoundly since the introduction of highly active antiretroviral therapy (HAART) at the end of 1996. Early initiation of HAART with reversal of severe immunodeficiency is the main factor responsible for the decreasing incidence and prevalence of pneumocystosis, extrapulmonary cryptococcosis, progressive disseminated histoplasmosis, coccidioidomycosis, and penicilliosis marneffei in AIDS patients. Nonetheless, in Western countries, these opportunistic mycoses still occur in patients who are unaware of their HIV status and in those failing to respond adequately to HAART.