WHO highlights leading health-threatening fungi for people living with HIV
On 25 October 2022, WHO published a report highlighting the first-ever list of fungal priority pathogens. Of the 19 fungi that represent the greatest threat to public health, 6 pathogens affect people living with HIV: Cryptococcus neoformans, histoplasma spp, Pneumocystis jirovecii, Talaromyces marneffei, Aspergillus fumigatus and Paracoccidioides.
These fungal infections are responsible for substantial hospitalization, illness and death among people living with HIV. Cryptococcus neoformans is the leading cause of cryptococcal disease which accounts for one in five AIDS-related deaths. Disseminated histoplasmosis is responsible for one in six AIDS-related deaths in the region of the Americas. Pneumocystis jirovecii causes pneumocystis pneumonia, a leading cause of mortality among hospitalized adults and children living with HIV. Talaromyces marneffei is endemic in South-East Asia and parts of China and India, where it is responsible for up to one in six hospital admissions, with substantial mortality. Pulmonary aspergillosis is relatively infrequent but commonly fatal infection among individuals with advanced HIV disease and severe neutropenia. And Paracoccidioides species are found in Central and South America, and infection can be fatal.
Taken together, these fungal pathogens are a major threat to public health as they are becoming increasingly common and resistant to treatment. The list established priorities based on factors such as mortality, complications from disease, antifungal resistance, preventability, and access to effective tests and treatments. It aims to highlight the increasing burden of antifungal resistance and the need to stimulate research and development. It is aimed at policymakers, health care providers, the pharmaceutical and diagnostics industry, academic and researchers.
The Department of HIV, Hepatitis and STI Programmes will incorporate these priority fungal infections into its guidance for people living with HIV and will support countries to implement interventions to prevent and treat these infections in line with the Advanced HIV disease comprehensive package care.
