Opportunistic Infections in the Immunocompromised: Hiv Vs Non-HIV Patients - A Narrative Review

Main Article Content

Inês Rego de Figueiredo Miguel Martins Carolina Midões Joana Branco Ferrão

Abstract

Opportunistic infections affect patients with immunocompromised status and are caused by common microorganisms with more severe presentations, or atypical organisms that do not cause disease in the immunocompetent. The type of infection varies with the type of immune dysfunction.


Patients with cell-mediated immune dysfunction tend to be infected with a range of viral infections, intracellular bacteria, and fungi. This contrasts to patients with defects in humoral immunity, where infections with encapsulated bacteria, and enteric organisms such Giardia lamblia and enteroviruses predominate. Patients with phagocytic defects are especially prone to infections with Gram-negative bacteria and fungi, whilst those with complement disorders are prone to recurrent infections with encapsulated bacteria. In contrast to patients with primary immunodeficiencies, which usually present with only one defect of the above, acquired immunodeficiencies present with a variety of those, and clinical presentations are diversified.


The epidemic of HIV and AIDS shed some light into infections that were before extremely rare, by making them frequent, but with the advent of anti-retroviral therapy their clinical presentation has shifted. Also, the emergence of novel immunotherapies for cancer and autoimmune diseases, allied with an increase in organ transplant has increased the pool of immunosuppressed patients without HIV, which present differently regarding opportunist infections.


Rapid and specific microbiologic diagnosis is essential. Newer microbiologic assays have improved the diagnosis and management of opportunistic infections.


Our aim was to revise and summarize the most frequent opportunist infections, and how their presentation and course compares in different immunosuppressed diseases (HIV and non-HIV).

Keywords: Opportunistic infections, HIV, immunosuppression

Article Details

How to Cite
FIGUEIREDO, Inês Rego de et al. Opportunistic Infections in the Immunocompromised: Hiv Vs Non-HIV Patients - A Narrative Review. Medical Research Archives, [S.l.], v. 10, n. 6, june 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2887>. Date accessed: 17 apr. 2024. doi: https://doi.org/10.18103/mra.v10i6.2887.
Section
Review Articles

References

1. Algar V, Novelli V. Infections in the immunocompromised host. Pediatr Child Heal. 2007;17(4):132-136. doi:10.1007/978-981-15-0898-1_56
2. Alothman A. of Kidney Diseases and Transplantation Infection Control and the Immunocompromised Host. J Hosp Infect. 2005;16(4):547-555.
3. Dropulic L, Lederman H. Overview of infections in the immunocompromised host. Microbiol Spectr. 2016;4(4). doi:10.1016/0002-9343(85)90129-9
4. Jos RJ, Periselneris JN, Brown JS. Opportunistic bacterial, viral and fungal infections of the lung. Published online 2020. doi:10.1016/j.mpmed.2020.03.006
5. Freeman A, Cuellar-Rodriguez J. Infections in the immunocompromised hots. In: Clinical Immunology. Fifth Edit. Elsevier Ltd; 2019. doi:10.1016/B978-0-7020-6896-6.00037-5
6. El Atrouni W, Berbari E, Temesgen Z. HIV-associated opportunistic infections. Bacterial infections. J Med Liban. 2006;54(2):80-83. Accessed May 23, 2022. https://europepmc.org/article/med/17086998
7. Anglaret X, Eholie SP. Severe bacterial infections: overlooked opportunistic diseases. Lancet HIV. 2017;4(3):e94-e95. doi:10.1016/S2352-3018(16)30213-2
8. O’Connor J, Vjecha MJ, Phillips AN, et al. Effect of immediate initiation of antiretroviral therapy on risk of severe bacterial infections in HIV-positive people with CD4 cell counts of more than 500 cells per μL: secondary outcome results from a randomised controlled trial. Lancet HIV. 2017;4(3):e105-e112. doi:10.1016/S2352-3018(16)30216-8/ATTACHMENT/1ACEC975-78EB-4931-A37D-801636021D25/MMC1.PDF
9. Brettle RP. Bacterial infections in HIV: The extent and nature of the problem. Int J STD AIDS. 1997;8(1):5-15. doi:10.1258/0956462971918698
10. Fishman JA. Opportunistic infections-coming to the limits of immunosuppression? Cold Spring Harb Perspect Med. 2013;3(10). doi:10.1101/cshperspect.a015669
11. Rego de Figueiredo I, Branco Ferrão J, Dias S, et al. Tuberculosis infection in HIV vs. non-HIV patients. HIV Med. 2021;22(8):775-779. doi:10.1111/hiv.13119
12. Aaron L, Saadoun D, Calatroni I, et al. Tuberculosis in HIV-infected patients: A comprehensive review. Clin Microbiol Infect. 2004;10(5):388-398. doi:10.1111/j.1469-0691.2004.00758.x
13. Barnes PF, Bloch AB, Davidson PT, Snider DE. Tuberculosis in patients with human immunodeficiency virus infection. Desforges JF, ed. N Engl J Med. 1991;324(23):1644-1650. doi:10.1056/NEJM199106063242307
14. Greenberg SD, Frager D, Suster B, Walker S, Stavropoulos C, Rothpearl A. Active pulmonary tuberculosis in patients with AIDS: spectrum of radiographic findings (including a normal appearance). Radiology. 1994;193(1):115-119. doi:10.1148/RADIOLOGY.193.1.7916467
15. Mathur M, Badhan RK, Kumari S, Kaur N, Gupta S. Radiological manifestations of pulmonary tuberculosis - A comparative study between immunocompromised and immunocompetent patients. J Clin Diagnostic Res. 2017;11(9):TC06-TC09. doi:10.7860/JCDR/2017/28183.10535
16. Henn L, Nagel F, Dal Pizzol F. Comparison between Human Immunodeficiency Virus Positive and Negative Patients with Tuberculosis in Southern Brazil. Mem Inst Oswaldo Cruz. 1999;94(3):377-381. doi:10.1590/S0074-02761999000300017
17. Kamble M, Kazi YK. Comparison of Treatment Outcomes among Tuberculosis Patients with HIV and Without HIV Infection in a Metropolitan City. 2019;10(9).
18. Silva DR, Menegotto DM, Schulz LF, Gazzana MB, Dalcin P de TR. Clinical characteristics and evolution of non-HIV-infected immunocompromised patients with an in-hospital diagnosis of tuberculosis. J Bras Pneumol. 2010;36(4):475-484. doi:10.1590/S1806-37132010000400013
19. Winburn B, Sharman T. Atypical Mycobacterial Disease. Accessed May 19, 2022. https://www.ncbi.nlm.nih.gov/books/NBK556117/
20. Griffith DE, Aksamit T, Brown-Elliott BA, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175(4):367-416. doi:10.1164/RCCM.200604-571ST
21. Sepkowitz KA. Opportunistic infections in patients with and patients without acquired immunodeficiency syndrome. Clin Infect Dis. 2002;34(8):1098-1107. doi:10.1086/339548
22. Karakousis PC, Moore RD, Chaisson RE. Mycobacterium avium complex in patients with HIV infection in the era of highly active antiretroviral therapy. Lancet Infect Dis. 2004;4(9):557-565. doi:10.1016/S1473-3099(04)01130-2
23. Nightingale SD, Byrd LT, Southern PM, Jockusch JD, Cal SX, Wynne BA. Incidence of Mycobacterium avium-intracellulare complex bacteremia in human immunodeficiency virus-positive patients. J Infect Dis. 1992;165(6):1082-1085. doi:10.1093/INFDIS/165.6.1082
24. Sepkowitz KA. Effect of HAART on natural history of AIDS-related opportunistic disorders. Lancet (London, England). 1998;351(9098):228-230. doi:10.1016/S0140-6736(05)78279-9
25. Horsburgh CR, Selik RM. The epidemiology of disseminated nontuberculous mycobacterial infection in the acquired immunodeficiency syndrome (AIDS). Am Rev Respir Dis. 1989;139(1):4-7. doi:10.1164/AJRCCM/139.1.4
26. Canueto-Quintero J, Caballero-Granado FJ, Herrero-Romero M, et al. Epidemiological, clinical, and prognostic differences between the diseases caused by Mycobacterium kansasii and Mycobacterium tuberculosis in patients infected with human immunodeficiency virus: a multicenter study. Clin Infect Dis. 2003;37(4):584-590. doi:10.1086/376987
27. Marras TK, Morris A, Gonzalez LC, Daley CL. Mortality prediction in pulmonary Mycobacterium kansasii infection and human immunodeficiency virus. Am J Respir Crit Care Med. 2004;170(7):793-798. doi:10.1164/RCCM.200402-162OC
28. Malouf MA, Glanville AR. The spectrum of mycobacterial infection after lung transplantation. Am J Respir Crit Care Med. 1999;160(5 Pt 1):1611-1616. doi:10.1164/AJRCCM.160.5.9808113
29. Henry MT, Inamdar L, O’Riordain D, Schweiger M, Watson JP. Nontuberculous mycobacteria in non‐HIV patients: epidemiology, treatment and response. Eur Respir J. 2004;23(5):741-746. doi:10.1183/09031936.04.00114004
30. Rego de Figueiredo I, Vieira Alves R, Drummond Borges D, et al. Pneumocystosis pneumonia: A comparison study between HIV and non-HIV immunocompromised patients. Pulmonology. 2019;25(5):271-274. doi:10.1016/j.pulmoe.2019.04.003
31. Morris A, Norris KA. Colonization by Pneumocystis jirovecii and its role in disease. Clin Microbiol Rev. 2012;25(2):297-317. doi:10.1128/CMR.00013-12
32. Latgé JP, Chamilos G. Aspergillus fumigatus and Aspergillosis in 2019. Clin Microbiol Rev. 2019;33(1). doi:10.1128/CMR.00140-18
33. Pagano L, Akova M, Dimopoulos G, Herbrecht R, Drgona L, Blijlevens N. Risk assessment and prognostic factors for mould-related diseases in immunocompromised patients. J Antimicrob Chemother. 2011;66(suppl_1):i5-i14. doi:10.1093/JAC/DKQ437
34. Walsh TJ, Anaissie EJ, Denning DW, et al. Treatment of Aspergillosis: Clinical Practice Guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2008;46(3):327-360. doi:10.1086/525258
35. Holding KJ, Dworkin MS, Wan PCT, et al. Aspergillosis among people infected with human immunodeficiency virus: incidence and survival. Adult and Adolescent Spectrum of HIV Disease Project. Clin Infect Dis. 2000;31(5):1253-1257. doi:10.1086/317452
36. Denning DW, Follansbee SE, Scolaro M, Norris S, Edelstein H, Stevens DA. Pulmonary aspergillosis in the acquired immunodeficiency syndrome. N Engl J Med. 1991;324(10):654-662. doi:10.1056/NEJM199103073241003
37. Humphrey JM, Walsh TJ, Gulick RM. Invasive Aspergillus Sinusitis in Human Immunodeficiency Virus Infection: Case Report and Review of the Literature. Published online 2016. doi:10.1093/ofid/ofw135
38. Marukutira T, Huprikar S, Azie N, Quan SP, Meier-Kriesche HU, Horn DL. Clinical characteristics and outcomes in 303 HIV-infected patients with invasive fungal infections: data from the Prospective Antifungal Therapy Alliance registry, a multicenter, observational study. HIV AIDS (Auckl). 2014;6:39-47. doi:10.2147/HIV.S53910
39. Minamoto GY, Barlam TF, Els NJY. Invasive aspergillosis in patients with AIDS. Clin Infect Dis. 1992;14(1):66-74. doi:10.1093/CLINIDS/14.1.66
40. Wallace JM, Lim R, Browdy BL, et al. Risk factors and outcomes associated with identification of Aspergillus in respiratory specimens from persons with HIV disease. Pulmonary Complications of HIV Infection Study Group. Chest. 1998;114(1):131-137. doi:10.1378/CHEST.114.1.131
41. Pursell KJ, Telzak EE, Armstrong D. Aspergillus species colonization and invasive disease in patients with AIDS. Clin Infect Dis. 1992;14(1):141-148. doi:10.1093/CLINIDS/14.1.141
42. Lortholary O, Meyohas MC, Dupont B, et al. Invasive aspergillosis in patients with acquired immunodeficiency syndrome: report of 33 cases. French Cooperative Study Group on Aspergillosis in AIDS. Am J Med. 1993;95(2):177-187. doi:10.1016/0002-9343(93)90258-Q
43. Brahm A, Segal H. Aspergillosis. N Engl J Med. 2009;360:1870-1884.
44. Mylonakis E, Barlam TF, Flanigan T, Rich JD. Pulmonary aspergillosis and invasive disease in AIDS: review of 342 cases. Chest. 1998;114(1):251-262. doi:10.1378/CHEST.114.1.251
45. Singh N, Paterson DL. Aspergillus infections in transplant recipients. Clin Microbiol Rev. 2005;18(1):44-69. doi:10.1128/CMR.18.1.44-69.2005
46. Wald A, Leisenring W, Van Burik JA, Bowden RA. Epidemiology of Aspergillus infections in a large cohort of patients undergoing bone marrow transplantation. J Infect Dis. 1997;175(6):1459-1466. doi:10.1086/516480
47. van Burik JAH, Carter SL, Freifeld AG, et al. Higher risk of cytomegalovirus and aspergillus infections in recipients of T cell-depleted unrelated bone marrow: analysis of infectious complications in patients treated with T cell depletion versus immunosuppressive therapy to prevent graft-versus-host disease. Biol Blood Marrow Transplant. 2007;13(12):1487-1498. doi:10.1016/J.BBMT.2007.08.049
48. Pagano L, Caira M, Picardi M, et al. Invasive Aspergillosis in patients with acute leukemia: update on morbidity and mortality--SEIFEM-C Report. Clin Infect Dis. 2007;44(11):1524-1525. doi:10.1086/517849
49. Denning DW. Aspergillosis in “nonimmunocompromised” critically ill patients. Am J Respir Crit Care Med. 2004;170(6):580-581. doi:10.1164/RCCM.2407004
50. Meersseman W, Vandecasteele SJ, Wilmer A, Verbeken E, Peetermans WE, Van Wijngaerdert E. Invasive aspergillosis in critically ill patients without malignancy. Am J Respir Crit Care Med. 2004;170(6):621-625. doi:10.1164/RCCM.200401-093OC
51. Vanderbeke L, Spriet I, Breynaert C, Rijnders BJA, Verweij PE, Wauters J. Invasive pulmonary aspergillosis complicating severe influenza: epidemiology, diagnosis and treatment. Curr Opin Infect Dis. 2018;31(6):471-480. doi:10.1097/QCO.0000000000000504
52. Schauwvlieghe AFAD, Rijnders BJA, Philips N, et al. Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a retrospective cohort study. Lancet Respir Med. 2018;6(10):782-792. doi:10.1016/S2213-2600(18)30274-1
53. Thompson GR, Cornely OA, Pappas PG, et al. Invasive Aspergillosis as an Under-recognized Superinfection in COVID-19. Open forum Infect Dis. 2020;7(7). doi:10.1093/OFID/OFAA242
54. Lahmer T, Kriescher S, Herner A, et al. Invasive pulmonary aspergillosis in critically ill patients with severe COVID-19 pneumonia: Results from the prospective AspCOVID-19 study. PLoS One. 2021;16(3). doi:10.1371/JOURNAL.PONE.0238825
55. Armstrong-James D, Meintjes G, Brown GD. A neglected epidemic: fungal infections in HIV/AIDS. Trends Microbiol. 2014;22:120-127. doi:10.1016/j.tim.2014.01.001
56. Thompson GR, Young J-AH. Aspergillus Infections. N Engl J Med. 2021;385(16):1496-1509. doi:10.1056/NEJMRA2027424/SUPPL_FILE/NEJMRA2027424_DISCLOSURES.PDF
57. Siddiqui S, Anderson VL, Hilligoss DM, et al. Fulminant mulch pneumonitis: an emergency presentation of chronic granulomatous disease. Clin Infect Dis. 2007;45(6):673-681. doi:10.1086/520985
58. Schmiedel Y, Zimmerli S. Common invasive fungal diseases: an overview of invasive candidiasis, aspergillosis, cryptococcosis, and Pneumocystis pneumonia. Swiss Med Wkly. 2016;146:w14281. doi:10.4414/SMW.2016.14281
59. Pappas PG, Rex JH, Lee J, et al. A prospective observational study of candidemia: epidemiology, therapy, and influences on mortality in hospitalized adult and pediatric patients. Clin Infect Dis. 2003;37(5):634-643. doi:10.1086/376906
60. Wingard JR, Anaissie EJ. Fungal Infections in the Immunocompromised Patient. Taylor & Francis; 2005.
61. Delgado ACD, de Jesus Pedro R, Aoki FH, et al. Clinical and microbiological assessment of patients with a long-term diagnosis of human immunodeficiency virus infection and Candida oral colonization. Clin Microbiol Infect. 2009;15(4):364-371. doi:10.1111/J.1469-0691.2009.02707.X
62. Fichtenbaum C. Candidiasis. In: Dolin R, Masur H, Saag M, eds. AIDS Therapy. 2nd ed. Churchill-Livingstone; 2003:531-542.
63. Patel PK, Erlandsen JE, Kirkpatrick WR, et al. The Changing Epidemiology of Oropharyngeal Candidiasis in Patients with HIV/AIDS in the Era of Antiretroviral Therapy. AIDS Res Treat. 2012;2012. doi:10.1155/2012/262471
64. Suryana K, Suharsono H, Antara IGPJ.

Factors Associated with Oral Candidiasis in People Living with HIV/AIDS: A Case Control Study

. HIV/AIDS - Res Palliat Care. 2020;12:33-39. doi:10.2147/HIV.S236304
65. Pfaller MA. Nosocomial candidiasis: emerging species, reservoirs, and modes of transmission. Clin Infect Dis. 1996;22 Suppl 2(SUPPL. 2). doi:10.1093/CLINIDS/22.SUPPLEMENT_2.S89
66. Asayama N, Nagata N, Shimbo T, et al. Relationship between clinical factors and severity of esophageal candidiasis according to Kodsi’s classification. Dis esophagus Off J Int Soc Dis Esophagus. 2014;27(3):214-219. doi:10.1111/DOTE.12102
67. Launay O, Lortholary O, Bouges-Michel C, Jarrousse B, Bentata M, Guillevin L. Candidemia: a nosocomial complication in adults with late-stage AIDS. Clin Infect Dis. 1998;26(5):1134-1141. doi:10.1086/520291
68. Tumbarello M, Tacconelli E, De Gaetano Donati K, Morace G, Fadda G, Cauda R. Candidemia in HIV-infected subjects. Eur J Clin Microbiol Infect Dis. 1999;18(7):478-483. doi:10.1007/S100960050327
69. de Oliveira RB, Atobe JH, Souza SA, de Castro Lima Santos DW. Epidemiology of Invasive Fungal Infections in Patients with Acquired Immunodeficiency Syndrome at a Reference Hospital for Infectious Diseases in Brazil. Mycopathologia. 2014;178(1-2):71-78. doi:10.1007/s11046-014-9755-3
70. Valdez H, Chowdhry TK, Asaad R, et al. Changing spectrum of mortality due to human immunodeficiency virus: analysis of 260 deaths during 1995--1999. Clin Infect Dis. 2001;32(10):1487-1493. doi:10.1086/320164
71. Darouiche RO. Oropharyngeal and esophageal candidiasis in immunocompromised patients: treatment issues. Clin Infect Dis. 1998;26(2):259-274. doi:10.1086/516315
72. Fichtenbaum CJ, Koletar S, Yiannoutsos C, et al. Refractory mucosal candidiasis in advanced human immunodeficiency virus infection. Clin Infect Dis. 2000;30(5):749-756. doi:10.1086/313765
73. Tacconelli E, Bertagnolio S, Posteraro B, et al. Azole susceptibility patterns and genetic relationship among oral Candida strains isolated in the era of highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2002;31(1):38-44. doi:10.1097/00126334-200209010-00005
74. Neofytos D, Fishman JA, Horn D, et al. Epidemiology and outcome of invasive fungal infections in solid organ transplant recipients. Transpl Infect Dis. 2010;12(3):220-229. doi:10.1111/J.1399-3062.2010.00492.X
75. Anttila VJ, Elonen E, Nordling S, Sivonen A, Ruutu T, Ruutu P. Hepatosplenic candidiasis in patients with acute leukemia: incidence and prognostic implications. Clin Infect Dis. 1997;24(3):375-380. doi:10.1093/CLINIDS/24.3.375
76. Pfaller MA, Diekema DJ. Epidemiology of invasive candidiasis: A persistent public health problem. Clin Microbiol Rev. 2007;20(1):133-163. doi:10.1128/CMR.00029-06
77. Gushiken AC, Saharia KK, Baddley JW. Cryptococcosis. Infect Dis Clin North Am. 2021;35(2):493-514. doi:10.1016/j.idc.2021.03.012
78. Speed B, Dunt D. Clinical and Host Differences Between Infections with the Two Varieties of Cryptococcus neoformans. Clin Infect Dis. 1995;21(1):28-34. doi:10.1093/CLINIDS/21.1.28
79. Sloan DJ, Parris V. Cryptococcal meningitis: epidemiology and therapeutic options. Clin Epidemiol. 2014;6(1):169-182. doi:10.2147/CLEP.S38850
80. Graybill JR, Sobel J, Saag M, et al. Diagnosis and management of increased intracranial pressure in patients with AIDS and cryptococcal meningitis. Clin Infect Dis. 2000;30(1):47-54. doi:10.1086/313603/2/30-1-47-TBL004.GIF
81. Perfect JR, Dismukes WE, Dromer F, et al. Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2010;50(3):291-322. doi:10.1086/649858
82. Maziarz EK, Perfect JR. Cryptococcosis. Infect Dis Clin North Am. 2016;30(1):179. doi:10.1016/J.IDC.2015.10.006
83. Cameron ML, Bartlett JA, Gallis HA, Waskin HA. Manifestations of pulmonary cryptococcosis in patients with acquired immunodeficiency syndrome. Rev Infect Dis. 1991;13(1):64-67. doi:10.1093/CLINIDS/13.1.64
84. Meyohas MC, Roux P, Bollens D, et al. Pulmonary cryptococcosis: localized and disseminated infections in 27 patients with AIDS. Clin Infect Dis. 1995;21(3):628-633. doi:10.1093/CLINIDS/21.3.628
85. Boulware DR, Meya DB, Bergemann TL, et al. Clinical Features and Serum Biomarkers in HIV Immune Reconstitution Inflammatory Syndrome after Cryptococcal Meningitis: A Prospective Cohort Study. PLOS Med. 2010;7(12):e1000384. doi:10.1371/JOURNAL.PMED.1000384
86. Zavala S, Baddley JW. Cryptococcosis. Semin Respir Crit Care Med. 2020;41(1):69-79. doi:10.1055/S-0039-3400280/ID/JR01508-42
87. Pappas PG, Alexander BD, Andes DR, et al. Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET). Clin Infect Dis. 2010;50(8):1101-1111. doi:10.1086/651262
88. Brizendine KD, Baddley JW, Pappas PG. Predictors of mortality and differences in clinical features among patients with Cryptococcosis according to immune status. PLoS One. 2013;8(3). doi:10.1371/JOURNAL.PONE.0060431
89. Baddley JW, Schain DC, Gupte AA, et al. Transmission of Cryptococcus neoformans by Organ Transplantation. Clin Infect Dis. 2011;52(4):e94-e98. doi:10.1093/CID/CIQ216
90. Husain S, Wagener MM, Singh N. Cryptococcus neoformans infection in organ transplant recipients: variables influencing clinical characteristics and outcome. Emerg Infect Dis. 2001;7(3):375. doi:10.3201/eid0703.017302
91. Henao-Martínez AF, Beckham JD. Cryptococcosis in solid organ transplant recipients. Curr Opin Infect Dis. 2015;28(4):300-307. doi:10.1097/QCO.0000000000000171
92. Wang Y, Gu Y, Shen K, et al. Clinical features of cryptococcosis in patients with different immune statuses: a multicenter study in Jiangsu Province-China. BMC Infect Dis. 2021;21(1). doi:10.1186/S12879-021-06752-X
93. Sun HY, Alexander BD, Lortholary O, et al. Cutaneous cryptococcosis in solid organ transplant recipients. Med Mycol. 2010;48(6):785-791. doi:10.3109/13693780903496617
94. Lortholary O, Fontanet A, Mémain N, Martin A, Sitbon K, Dromer F. Incidence and risk factors of immune reconstitution inflammatory syndrome complicating HIV-associated cryptococcosis in France. AIDS. 2005;19(10):1043-1049. doi:10.1097/01.AIDS.0000174450.70874.30
95. Gupta AO, Singh N. Immune reconstitution syndrome and fungal infections. Curr Opin Infect Dis. 2011;24(6):527-533. doi:10.1097/QCO.0B013E32834AB20A
96. Sun HY, Wagener MM, Singh N. Cryptococcosis in solid-organ, hematopoietic stem cell, and tissue transplant recipients: evidence-based evolving trends. Clin Infect Dis. 2009;48(11):1566-1576. doi:10.1086/598936
97. Schmalzle SA, Buchwald UK, Gilliam BL, Riedel DJ. Cryptococcus neoformans infection in malignancy. Mycoses. 2016;59(9):542-552. doi:10.1111/MYC.12496
98. González LA, Vásquez G, Restrepo JP, Velásquez M, Ramírez LA. Cryptococcosis in systemic lupus erythematosus: a series of six cases. Lupus. 2010;19(5):639-645. doi:10.1177/0961203309356458
99. Davis MR, Thompson GR, Patterson TF. Fungal Infections Potentiated by Biologics. Infect Dis Clin North Am. 2020;34(2):389-411. doi:10.1016/J.IDC.2020.02.010
100. Thabet C, Sherazi A, Cowan J. Toxoplasmosis, cryptosporidiosis, and isosporiasis in HIV-negative immunocompromised patients: A single-centre study, Ottawa, Ontario, Canada. J Assoc Med Microbiol Infect Dis Canada. 2020;5(4):239-244. doi:10.3138/JAMMI-2020-0024/ASSET/IMAGES/SMALL/JAMMI-2020-0024_FIG1.GIF
101. Ferreira MS, Borges AS. Some Aspects of Protozoan Infections in Immunocompromised Patients: A Review. Mem Inst Oswaldo Cruz. 2002;97(4):443-457. doi:10.1590/S0074-02762002000400001
102. Evering T, Weiss LM. The immunology of parasite infections in immunocompromised hosts. Parasite Immunol. 2006;28(11):549. doi:10.1111/J.1365-3024.2006.00886.X
103. Shu Kurizky P, dos Santos Neto LL, Barbosa Aires R, Henrique da Mota LM, Martins Gomes C. Opportunistic tropical infections in immunosuppressed patients. Best Pract Res Clin Rheumatol. 2020;34(4). doi:10.1016/J.BERH.2020.101509
104. Barratt JLN, Harkness J, Marriott D, Ellis JT, Stark D. Importance of Nonenteric Protozoan Infections in Immunocompromised People. Clin Microbiol Rev. 2010;23(4):795. doi:10.1128/CMR.00001-10
105. Eckmann L. Mucosal defences against Giardia. Parasite Immunol. 2003;25(5):259-270. doi:10.1046/J.1365-3024.2003.00634.X
106. Soave R, Johnson WD. Cryptosporidium and Isospora belli infections. J Infect Dis. 1988;157(2):225-229. doi:10.1093/INFDIS/157.2.225
107. Welch PC, Masur H, Jones TC, Remington JS. Serologic diagnosis of acute lymphadenopathic toxoplasmosis. J Infect Dis. 1980;142(2):256-264. doi:10.1093/INFDIS/142.2.256
108. JD Y, BS M. Infliximab and reactivation of cerebral toxoplasmosis. N Engl J Med. 2005;353(14):1530-1531. doi:10.1056/NEJMC051556
109. Griffiths P, Reeves M. Pathogenesis of human cytomegalovirus in the immunocompromised host. Nat Rev Microbiol 2021 1912. 2021;19(12):759-773. doi:10.1038/s41579-021-00582-z
110. Chaemsupaphan T, Limsrivilai J, Thongdee C, et al. Patient characteristics, clinical manifestations, prognosis, and factors associated with gastrointestinal cytomegalovirus infection in immunocompetent patients. BMC Gastroenterol. 2020;20(1):1-12. doi:10.1186/S12876-020-1174-Y/TABLES/4
111. Brambilla L, Tourlaki A, Genovese G. Iatrogenic Kaposi’s Sarcoma: a Retrospective Cohort Study in an Italian Tertiary Care Centre. Clin Oncol (R Coll Radiol). 2017;29(10):e165-e171. doi:10.1016/J.CLON.2017.05.008
112. Grabar S, Costagliola D. Epidemiology of Kaposi’s Sarcoma. Cancers (Basel). 2021;13(22). doi:10.3390/CANCERS13225692
113. Ibrahim Khalil A, Franceschi S, de Martel C, Bray F, Clifford GM. Burden of Kaposi sarcoma according to HIV status: A systematic review and global analysis. Int J cancer. 2022;150(12):1948-1957. doi:10.1002/IJC.33951
114. Brambilla L, Genovese G, Berti E, et al. Diagnosis and treatment of classic and iatrogenic Kaposi’s sarcoma: Italian recommendations. Ital J dermatology Venereol. 2021;156(3):356-365. doi:10.23736/S2784-8671.20.06703-6
115. Cesarman E, Damania B, Krown SE, Martin J, Bower M, Whitby D. Kaposi sarcoma. Nat Rev Dis Prim 2019 51. 2019;5(1):1-21. doi:10.1038/s41572-019-0060-9
116. Vangipuram R, Tyring SK. Epidemiology of Kaposi sarcoma: review and description of the nonepidemic variant. Int J Dermatol. 2019;58(5):538-542. doi:10.1111/IJD.14080
117. Cahoon EK, Linet MS, Clarke CA, Pawlish KS, Engels EA, Pfeiffer RM. Risk of Kaposi sarcoma after solid organ transplantation in the United States. Int J cancer. 2018;143(11):2741-2748. doi:10.1002/IJC.31735
118. Lebbe C, Garbe C, Stratigos AJ, et al. Diagnosis and treatment of Kaposi’s sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC). Eur J Cancer. 2019;114:117-127. doi:10.1016/J.EJCA.2018.12.036
119. Reddy NA, Mays SR, Pacha O. Kaposi’s Sarcoma in the Immunosuppressed. J Immunother Precis Oncol. 2019;2(3):74-78. doi:10.4103/JIPO.JIPO_10_19
120. Windon AL, Shroff SG. Iatrogenic Kaposi’s Sarcoma in an HIV-Negative Young Male With Crohn’s Disease and IgA Nephropathy: A Case Report and Brief Review of the Literature. Int J Surg Pathol. 2018;26(3):276-282. doi:10.1177/1066896917736610
121. Endo G, Nagata N. Corticosteroid-induced Kaposi’s Sarcoma Revealed by Severe Anemia: A Case Report and Literature Review. Intern Med. 2020;59(5):625-631. doi:10.2169/INTERNALMEDICINE.3394-19
122. Pellett Madan R, Hand J. Human herpesvirus 6, 7, and 8 in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9). doi:10.1111/CTR.13518
123. Delyon J, Rabate C, Euvrard S, et al. Management of Kaposi sarcoma after solid organ transplantation: A European retrospective study. J Am Acad Dermatol. 2019;81(2):448-455. doi:10.1016/J.JAAD.2019.03.028
124. Chan CK, Aimagambetova G, Ukybassova T, Kongrtay K, Azizan A. Human Papillomavirus Infection and Cervical Cancer: Epidemiology, Screening, and Vaccination-Review of Current Perspectives. J Oncol. 2019;2019. doi:10.1155/2019/3257939
125. Kombe Kombe AJ, Li B, Zahid A, et al. Epidemiology and Burden of Human Papillomavirus and Related Diseases, Molecular Pathogenesis, and Vaccine Evaluation. Front public Heal. 2021;8. doi:10.3389/FPUBH.2020.552028
126. St. Laurent J, Luckett R, Feldman S. HPV vaccination and the effects on rates of HPV-related cancers. Curr Probl Cancer. 2018;42(5):493-506. doi:10.1016/J.CURRPROBLCANCER.2018.06.004
127. Brianti P, De Flammineis E, Mercuri SR. Review of HPV-related diseases and cancers.
128. de Sanjosé S, Brotons M, Pavón MA. The natural history of human papillomavirus infection. Best Pract Res Clin Obstet Gynaecol. 2018;47:2-13. doi:10.1016/J.BPOBGYN.2017.08.015
129. Njue JK, Muturi M, Kamau L, Lwembe R. Human Papillomavirus Types Associated with Cervical Dysplasia among HIV- and Non-HIV-Infected Women Attending Reproductive Health Clinics in Eastern Kenya. Biomed Res Int. 2021;2021. doi:10.1155/2021/2250690
130. Hemmat N, Bannazadeh Baghi H. Association of human papillomavirus infection and inflammation in cervical cancer. Pathog Dis. 2019;77(5). doi:10.1093/FEMSPD/FTZ048
131. Serrano B, Brotons M, Bosch FX, Bruni L. Epidemiology and burden of HPV-related disease. Best Pract Res Clin Obstet Gynaecol. 2018;47:14-26. doi:10.1016/J.BPOBGYN.2017.08.006
132. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Accessed May 24, 2022. https://www.idsociety.org/practice-guideline/prevention-and-treatment-of-opportunistic-infections-among-adults-and-adolescents/
133. Lin C, Franceschi S, Clifford GM. Human papillomavirus types from infection to cancer in the anus, according to sex and HIV status: a systematic review and meta-analysis. Lancet Infect Dis. 2018;18(2):198. doi:10.1016/S1473-3099(17)30653-9
134. Wielgos AA, Pietrzak B. Human papilloma virus-related premalignant and malignant lesions of the cervix and anogenital tract in immunocompromised women. Ginekol Pol. 2020;91(1):32-37. doi:10.5603/GP.2020.0008
135. Boudes M, Venard V, Routiot T, Buzzi M, Maillot F. Prevalence and Distribution of HPV Genotypes in Immunosuppressed Patients in Lorraine Region. Viruses. 2021;13(12). doi:10.3390/V13122454
136. Chin-Hong P V., Reid GE. Human papillomavirus infection in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9). doi:10.1111/CTR.13590