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. 2014 Aug 28;8(8):e3110.
doi: 10.1371/journal.pntd.0003110. eCollection 2014 Aug.

Sporotrichosis: An Emerging Neglected Opportunistic Infection in HIV-infected Patients in Rio De Janeiro, Brazil

Free PMC article

Sporotrichosis: An Emerging Neglected Opportunistic Infection in HIV-infected Patients in Rio De Janeiro, Brazil

Dayvison Francis Saraiva Freitas et al. PLoS Negl Trop Dis. .
Free PMC article


Sporotrichosis associated with zoonotic transmission remains a relevant public health problem in Rio de Janeiro, Brazil, affecting a large at-risk population, which includes HIV-infected individuals. We assessed patients co-infected by Sporothrix spp. and HIV over time in the context of an unabated sporotrichosis epidemic. A retrospective cohort retrieved information from a National reference institute for infectious diseases regarding 48 patients with sporotrichosis-HIV co-infection (group 1) as well as 3,570 patients with sporotrichosis (group 2), from 1987 through March 2013. Most patients from group 1 were male (68.8%), whereas women were predominant in group 2 (69.1%; p<0.0001). Patients from group 1 were younger than those from group 2 (μ = 38.38±10.17 vs. 46.34±15.85; p<0.001) and differed from group 2 in terms of their race/ethnic background, with 70.8% non-white patients in group 1 vs. 38.6% from group 2 (p<0.0001). Close to half (∼44%) of the patients from group 1 were hospitalized due to sporotrichosis over time, whereas hospitalization was very unlikely in group 2, among whom approximately 1% were hospitalized over time. Dissemination of sporotrichosis was the main cause of hospitalization in both groups, although it was more common among hospitalized patients from group 1 (19/21 [90.5%] vs. 16/37 [43.2%]; p<0.001). Over the period under analysis, eight patients died due to sporotrichosis (3/48 vs. 5/3,570). The diagnosis of sporotrichosis elicited HIV testing and subsequent diagnosis in 19/48 patients, whereas 23/48 patients were simultaneously diagnosed with the two infections. HIV infection aggravates sporotrichosis, with a higher incidence of severe disseminated cases and a higher number of hospitalizations and deaths. Underserved populations, among whom sporotrichosis has been propagated, have been affected by different transmissible (e.g., HIV) and non-transmissible diseases. These populations should be targeted by community development programs and entitled to integrated management and care of their superimposed burdens.

Conflict of interest statement

The authors have declared that no competing interests exist.


Figure 1
Figure 1. Annual number of patients with sporotrichosis at IPEC from 1987 through March 2013.
A) Sporotrichosis and HIV (group 1) and B) annual proportion of patients diagnosed with sporotrichosis among all patients diagnosed at IPEC.

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Grant support

Financial support was received from FAPERJ/Rio de Janeiro, Brazil (grant proc. E-26/110.619/2012) and PAPES VI – CNPq/Fiocruz (grant proc. 407693/2012-2). DFSF received financial support from CNPq and CAPES. RMZO was supported in part by CNPq (350338/2000-0) and FAPERJ (E-26/103.157/2011). MCGG received partial funding from the Brazilian National STD/AIDS Program, Ministry of Health (46/CV079/2006). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.