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Theses

L’histoplasmose chez le patient infecté par le VIH en Guyane française

Abstract : Histoplasmosis is an invasive fungal infection, known as one of the first AIDS-defining condition and AIDS-related deaths in French Guiana.Several scientific programmes were conducted. Ranked as the main AIDS-defining condition, histoplasmosis incidence was estimated at 1.5 p100 person-years HIV-infected. The high number of incident cases was stable and the proportion of early deaths was <10%. Following a significant increase in incidence between the end of the long dry season and the beginning of the short wet season, new infection might be the main pathophysiological mechanism leading to symptomatic disease in endemic areas. Comparison of tuberculosis and histoplasmosis in HIV-infected patients found a respiratory clinical picture in a context of pronounced inflammation and, a disseminated disease along with cytopenia and liver test abnormalities in individuals with greater immunosuppression, respectively. An evaluation of galactomannan antigen detection in serum was relevant for histoplasmosis diagnosis. Reframed severity criteria and arguments for an empiric strategy using antifungal therapy were proposed.Preliminary results showed the presence (in Suriname and Guyana) and a high incidence of histoplasmosis among HIV-infected patients in Suriname. In the whole Latin American region, we estimated that AIDS-related histoplasmosis deaths were similar or greater than AIDS-related tuberculosis deaths. HIV-associated histoplasmosis is in fact neglected, largely unknown and responsible for numerous avoidable deaths in Latin America.
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Submitted on : Friday, July 6, 2018 - 7:21:06 PM
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Antoine Adenis. L’histoplasmose chez le patient infecté par le VIH en Guyane française. Virologie. Université de Guyane, 2017. Français. ⟨NNT : 2017YANE0014⟩. ⟨tel-01832278⟩

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