Fungal Infections Epidemiology in A Population of PLHIV Hospitalized in the Centre Hospitalier Universitaire De Libreville / Gabon

Opportunistic infections are important causes of death in HIV-infected patients. Moreover, management of the patients depends on knowledge of current epidemiology, risk factors, diagnosis and appropriate treatment. The aim of this study is to determine fungal opportunistic infection and associated factors among HIV-infected patients hospitalized in the infectious diseases ward of the Centre Hospitalier Universitaire de Libreville in Gabon. A cross-sectional study was carried out from April to October 2021. The study population was composed of patients admitted to the infectious diseases ward. Data including patients’ demographics and clinical characteristics, comorbidities, existing ART or antifungal therapies were collected. For each participant, samples have been collected and laboratory tests were performed to detect Candida and Cryptococcus infections. Of the 255 patients, 72.5% (n=185) were female and 86.2% (n=220) adults. Most of the patients were at WHO clinical stage I (45.5%) and III/IV (42.4%). More than half of the patients (n=122) had a CD4 cells count ≤ 200. ART intake was frequently reported by the participants (n=216) and one-third received antifungal therapy. Among patients, 211 had OIs; 29 (11.4%) were co-infected. Oropharyngeal candidiasis was diagnosed in 80.3% (n=205) of the inpatients. Neuromeningeal cryptococcosis affected 24.6% (n=35) of the participants, almost (82.8%; n=29/35) had candidiasis. A decreasing CD4 cell count was significantly associated with higher prevalence of Oropharyngeal candidiasis and coinfections.