Dermatophytosis and immunovirological status of HIV‐infected and AIDS patients from Sao Paulo city, Brazil

Abstract

Over the past decades, more people became infected with human immunodeficiency virus (HIV) and developed acquired immunodeficiency syndrome (AIDS). Because of that the incidence of fungal infections rose dramatically. It happened because this virus can modify the course of fungal diseases, leading to altered clinical pictures. The aim of this study was to evaluate epidemiological and biological aspects of dermatophytosis in HIV-positive and AIDS patients living in the city of São Paulo, Brazil. A total of 84 (44 HIV-positive and 40 AIDS) patients were enrolled in this study. The patients were tested for dermatophyte infections, as well as for the CD4(+) /CD8(+) and HIV viral load counts. Tinea unguium was most frequently observed in AIDS patients, whereas Tinea pedis was mostly observed in HIV-positive patients. The most frequent dermatophyte species was Trichophyton rubrum. CD4(+) counts and CD4(+) /CD8(+) ratios were not associated with a higher risk for dermatophytosis. On the other hand, viral load higher than 100 000 copies/ml was associated with a higher frequency of dermatophytosis. The results suggest to that although dermatophytosis is common in HIV-positive and AIDS patients, the degree of immunosuppression does not seems to correlate with increased risk of this fungal infection. In addition, high viral load as a predictive risk factor for dermatophyte infection should be subject of further evaluations.

Dermatophytes Species Isolated of HIV-Infected Patients Identified by ITS-RFLP and ITS Region Sequencing from Triangulo Mineiro, Minas Gerais State of Brazil

“…The severity of the nail involvement with chronic and distrophic changes and a poor antifungal response is a common clinical observation in these patients. This finding agrees with literature data and confirms the results from a recent Brazilian survey where onicomycosis and Tinea pedis were the most common clinical pictures in 84 HIV-infected patients evaluated [27]. In contrast, another study from the same country described a high frequency (70%) of Tinea corporis in 20 HIV-infected patients [28].…”

A Homozygous CARD9 Mutation in a Brazilian Patient with Deep Dermatophytosis

“…In rare cases, dermatophyte infection can lead to deep dermatophytosis with the invasion of the dermis and hypodermis by dermatophytes, sometimes affecting lymph nodes, brain, digestive tract and bones [2]. Most cases of deep dermatophytosis have been reported among HIV patients or patients on immunosuppressive therapy [3]. However, a number of cases were reported with deep dermatophytosis but otherwise healthy, mainly from North Africa, often born to consanguineous families and/or multiplex families, suggesting a genetic origin for the disease [4].…”

Expression of genes containing tandem repeat patterns involved in the fungal‐host interaction and in the response to antifungals inTrichophyton rubrum

“…Trichophyton rubrum is an important pathogen because it is responsible for most cases of dermatophytosis and is becoming a public health, especially when affecting individuals with a compromised immune system 1,29 . Tandem repeats have been implicated in the virulence of some organisms, such as S cerevisiae 16 .…”