Emerging fungal infections in the immunocompromised host

Quantifying Deaths from Aspergillosis in HIV Positive People

Aspergillus spp. are ubiquitous and cause severe infections in immunocompromised patients. Less is known about its incidence and prognosis in patients with HIV/AIDS. We reviewed the mortality of invasive aspergillosis in HIV/AIDS patients. Pubmed, Embase and Medline databases were used to search for articles. Studies were excluded if they contained other aspergillosis risk factors, no original or patient survival data or were not in English. From 747 articles published, 54 studies and case reports were identified following reading, published between 1985 and 2021, with 54% papers prior to 2000 reporting 853 patients from 16 countries, none from Africa. 707 (83%) patients died with an average time from diagnosis to death of 77.5 days. Postmortem diagnosis was seen in 21% of deaths recorded. A national series from France of 242 cases of invasive aspergillosis diagnosed in life recorded a 3 month mortality of 68% pre-ART, falling to 31% after introduction of ART and voriconazole. CD4 count was recorded in 39 studies and ranged from 2 to >1000 cells/mm3; only 8 patients (1.8%) had a CD4 > 100 cells/mm3. Aspergillosis occurs in patients with HIV/AIDS and associated with high mortality but its slow progression should allow diagnosis and treatment with improved outcome.

The antifungal activity of extracts of Osmundea pinnatifida, an edible seaweed, indicates its usage as a safe environmental fungicide or as a food additive preventing post-harvest fungal food contamination

In the present work, we explored the antifungal activity of the wild edible seaweed Osmundea pinnatifida (Rhodophyta) collected from the Portuguese coast, which is used as a food seasoning in Scotland, Ireland and Portugal. We performed a sequential extraction of the seaweed components with methanol, dichloromethane and n-hexane. These extracts showed an antifungal activity against Alternaria infectoria and Aspergillus fumigatus. The n-hexane fraction of the seaweed inhibited the sporulation of Alternaria infectoria at 30 μg mL-1 and induced a statistically significant (P < 0.001) decrease in β-glucan content. Furthermore, liquid cultures of Aspergillus fumigatus supplemented with 10 μg mL-1 of the n-hexane fraction showed abnormal conidiophores, completely devoid of phialides and conidia associated with a decrease of 18.3% in the chitin content (P < 0.01). The n-hexane fraction analysis by GC-MS revealed that it includes palmitic acid (29.6%), phytol isomer 1 (12.8%), oleic acid (9.6%), stearic acid (6.2%) and d-(-)-tagatofuranose (4.1%), among other compounds present at lower concentrations. The present study reveals Osmundea pinnatifida as a promising source of biologically active compounds inhibiting fungal growth and conidiation, the main dispersal mechanism of filamentous fungi as Aspergillus fumigatus and Alternaria alternata, revealing its utility both as an environmental fungicide against fungal diseases and as a food preservative against fungal post-harvest food contamination.