HIV and fungal priority pathogens

Affiliations

¹ Antimicrobial Resistance Division, WHO, Geneva, Switzerland.
² Mycology Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain.
³ Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
⁴ National Institute for Communicable Diseases, Division of the National Health Laboratory Service, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; MRC Centre for Medical Mycology, University of Exeter, Exeter, UK.
⁵ Centre for Global Health, Institute of Infection and Immunity, St George's University of London, London, UK; MRC Centre for Medical Mycology, University of Exeter, Exeter, UK.
⁶ Centers for Disease Control and Prevention, Atlanta, GA, USA.
⁷ Sydney Infectious Disease Institute, University of Sydney, Sydney, NSW, Australia.
⁸ Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.
⁹ Department of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria.
¹⁰ Doodhdhari Burfani Hospital and Research Institute, Haridwar, India.
¹¹ Department of Parasitology, Universitas Indonesia and Universitas Kristen Indonesia, Indonesia.
¹² Department of Medicine, Division of Infectious Diseases, Federal University of São Paulo, São Paulo, Brazil.
¹³ Global Action for Fungal Infections, Geneva, Switzerland.
¹⁴ Duke Global Health Institute, Duke University, Durham, NC, USA.
¹⁵ Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland; Centre for Infectious Disease and Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. Electronic address: fordn@who.int.

PMID: 37827187
PMCID: PMC7615271
DOI: 10.1016/S2352-3018(23)00174-1

Review

HIV and fungal priority pathogens

Hatim Sati et al. Lancet HIV. 2023 Nov.

. 2023 Nov;10(11):e750-e754.

doi: 10.1016/S2352-3018(23)00174-1. Epub 2023 Oct 9.

Authors

Affiliations

¹ Antimicrobial Resistance Division, WHO, Geneva, Switzerland.
² Mycology Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain.
³ Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
⁴ National Institute for Communicable Diseases, Division of the National Health Laboratory Service, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; MRC Centre for Medical Mycology, University of Exeter, Exeter, UK.
⁵ Centre for Global Health, Institute of Infection and Immunity, St George's University of London, London, UK; MRC Centre for Medical Mycology, University of Exeter, Exeter, UK.
⁶ Centers for Disease Control and Prevention, Atlanta, GA, USA.
⁷ Sydney Infectious Disease Institute, University of Sydney, Sydney, NSW, Australia.
⁸ Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.
⁹ Department of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria.
¹⁰ Doodhdhari Burfani Hospital and Research Institute, Haridwar, India.
¹¹ Department of Parasitology, Universitas Indonesia and Universitas Kristen Indonesia, Indonesia.
¹² Department of Medicine, Division of Infectious Diseases, Federal University of São Paulo, São Paulo, Brazil.
¹³ Global Action for Fungal Infections, Geneva, Switzerland.
¹⁴ Duke Global Health Institute, Duke University, Durham, NC, USA.
¹⁵ Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland; Centre for Infectious Disease and Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. Electronic address: fordn@who.int.

PMID: 37827187
PMCID: PMC7615271
DOI: 10.1016/S2352-3018(23)00174-1

Abstract

The burden of invasive fungal infections associated with opportunistic fungal pathogens is a persistent challenge, particularly among people with advanced HIV disease. In October, 2022, WHO published the Fungal Priority Pathogens List (FPPL)-the first global effort to systematically prioritise fungal pathogens. Of the 19 pathogens in the WHO FPPL, four opportunistic pathogens in particular cause invasive diseases in people living with HIV: Cryptococcus neoformans, Histoplasma spp, Pneumocystis jirovecii, and Talaromyces marneffei. These four fungal pathogens are major causes of illness and death in people with advanced HIV and overwhelmingly affect those in low-income and middle-income countries. Access to diagnostics, improved surveillance, targeted support for innovation, and an enhanced public health focus on these diseases are needed in the effort to reduce HIV-associated deaths.

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Conflict of interest statement

Declaration of interests NPG has received grants from National Institute for Health Research, US Centers for Disease Control and Prevention, US National Institutes of Health, UK Medical Research Council, the Bill & Melinda Gates Foundation, and the National Health Laboratory Service Research Trust. AA-I has received honoraria from Pfizer and Gilead for educational lectures; and is the chair of WHO's technical expert group for the development of the final priority pathogen list, chair of the fungal infection study group for the European Society of Clinical Microbiology and Infectious Diseases, president of the Spanish Society for Mycology, director of Latin American Programs for Global Action Fund for Fungal Infections, and a member of the scientific advisory board of the Joint Programming Initiative on Antimicrobial Resistance. HS has received grants from the Governments of Austria and Germany, the European Union Health Emergency Preparedness and Response, the US Centers for Disease Control and Prevention, and the Golden Key International Honour Society. JP has received grants from the US National Institutes of Health; and is the president of International Society for Human and Animal Mycology and the past president of the Mycoses Study Group Education & Research Consortium. AC has received personal and institutional payments from ACHE, Eurofarma, Gilead, Mundipharma, Knight-Biotoscana, and Pfizer; and has obtained financial support for travel from Knight-Biotoscana. All other authors declare no competing interests.

Figures

**Figure. Prevention, diagnosis, and treatment of HIV-associated infections caused by priority fungal pathogens in low-income and middle-income countries**

See this image and copyright information in PMC

References

1. WHO. Fungal Priority Pathogens List to guide research, development, and public health action. 2022. [accessed Sept 14, 2023]. https://www.who.int/publications/i/item/9789240060241 .
1. Morgan J, McCarthy KM, Gould S, et al. Cryptococcus gattii infection: characteristics and epidemiology of cases identified in a South African province with high HIV seroprevalence, 2002—04. Clin Infect Dis. 2006;43:1077–80. - PubMed
1. Rajasingham R, Smith RM, Park BJ, et al. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. Lancet Infect Dis. 2017;17:873–81. - PMC - PubMed
1. Rajasingham R, Govender NP, Jordan A, et al. The global burden of HIV-associated cryptococcal infection in adults in 2020: a modelling analysis. Lancet Infect Dis. 2022;22:1748–55. - PMC - PubMed
1. Kalata N, Ellis J, Kanyama C, et al. Short-term mortality outcomes of HIV-associated cryptococcal meningitis in antiretroviral therapy naïve and therapy-experienced patients in sub-Saharan Africa. Open Forum Infect Dis. 2021;8:ofab397. - PMC - PubMed

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HIV and fungal priority pathogens

Affiliations

HIV and fungal priority pathogens

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous