COCCIDIOIDOMYCOSIS AMONG PERSONS WITH AIDS IN THE UNITED-STATES

Adults and adolescents diagnosed with AIDS from 1987 through 1992 resi ding in counties endemic (selected counties in California, Arizona, Te xas, New Mexico, Nevada, and Utah) and not endemic for Coccidioides im mitis were assessed to determine the frequency of and risk factors for disseminated coccidioidomycosis, Of 602 AIDS patients reported with d isseminated coccidioidomycosis, 323 (1.1% of AIDS patients) resided in C. immitis-endemic counties and 279 (0.1% of AIDS patients) resided i n C. immitis-nonendemic counties in 35 states. In multivariate analysi s, patients with disseminated coccidioidomycosis in C. immitis-endemic counties were more likely to be injecting drug users (odds ratio, 2.6 ; 95% confidence interval, 1.8-3.7) and blood product recipients (odds ratio, 3.6; 95% confidence interval, 1.5-8.3) than to be homosexual o r bisexual men, Of patients with disseminated coccidioidomycosis, 63% had died by 1 year after AIDS diagnosis, Disseminated coccidioidomycos is should be considered in AIDS patients in all areas of the United St ates.