Aspergillosis among people infected with human immunodeficiency virus: Incidence and survival

Aspergillosis is a life-threatening fungal infection in immunocompromised p eople, including people infected with human immunodeficiency virus (HIV). W e determined the incidence of aspergillosis among HIV-infected people and s urvival after aspergillosis diagnosis by use of a national HIV surveillance database. Among 35,252 HIV-infected patients, the incidence of aspergillos is was 3.5 cases per 1000 person-years (p-y; 95% confidence interval [CI], 3.0-4.0 per 1000 p-y). Incidence was higher among people aged greater than or equal to 35 years (4.1 per 1000 p-y, 95% CI, 3.5-4.8), among people with CD4 counts of 50-99 cells/mm(3) (5.1 per 1000 p-y, 95% CI, 2.8-7.3), or CD 4 counts of <50 cells/mm(3) (10.2 per 1000 p-y, 95% CI, 8.0-12.2), versus p eople with CD4 counts of >200 cells/mm(3), people with greater than or equa l to1 acquired immune deficiency syndrome-defining opportunistic illness (8 .6 per 1000 p-y, 95% CI, 7.4-9.9), and people who were prescribed at least one medication associated with neutropenia (27.7 per 1000 p-y, 95% CI, 21.0 -34.3). Median survival time after diagnosis of aspergillosis was 3 months, and 26% survived for greater than or equal to1 year. These findings sugges t that aspergillosis is uncommon, occurs especially among severely immunosu ppressed or leukopenic HIV-infected people, and is associated with poor sur vival.