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Volume 31, Number 7—July 2025

Research

Disseminated Histoplasmosis in Persons Living with HIV, France and Overseas Territories,1992–2021

Mathieu NacherComments to Author , Esaïe Marshall, Firouze Bani-Sadr, Sandrine Peugny, Blandine Denis, Elise Ouedraogo, Sebastien Gallien, Agnes Meybeck, Ugo Françoise, Antoine Adenis, Nicolas Vignier, Pierre Couppié, Pierre Sellier, and Sophie Grabar
Author affiliation: Centre Hospitalier Universitaire de Guyane, Cayenne, French Guiana (M. Nacher, A. Adenis, N. Vignier); Université de Guyane, Cayenne (M. Nacher, A. Adenis, P. Couppié); Santé des Populations en Amazonie, Cayenne (M. Nacher, A. Adenis, P. Couppié); Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France (E. Marshall, S. Grabar); Centre Hospitalier Universitaire de Reims, Reims, France (F. Bani-Sadr); Centre Hospitalier Universitaire de Guadeloupe, Les Abymes, Guadeloupe (S. Peugny); Hôpital Saint Louis, Paris, France (B. Denis); Centre Hospitalier Universitaire La Pitié Salpêtrière, Paris (E. Ouedraogo); Hôpital Henri-Mondor, Créteil, France (S. Gallien); Centre Hospitalier de Tourcoing, Tourcoing, France (A. Meybeck); Hôpital Saint Antoine, Paris, France (U. Françoise); Hôpital Avicenne, Bobigny, France (U. Françoise, N. Vignier); Université Paris Cité, Paris, France (N. Vignier); Université Sorbonne Paris Nord, Paris (N. Vignier); Centre Hospitalier Universitaire de Guyane, Cayenne, French Guiana (P. Couppié); Hôpital Lariboisière, Paris, France (P. Sellier); Hôpital St Antoine, Paris (S. Grabar)

Main Article

Table 2

Crude and adjusted hazard ratios for disseminated histoplasmosis in persons living with HIV from France and overseas territories of France,1992–2021.

Variable Person-time, y First events Hazard ratio (95% CI)
 p value
Crude Adjusted†
Sex <0.0001
M 1,438,462 352 Referent Referent
F
 741,990
 197
 1.1 (0.92–1.30)
 0.50 (0.40–0.63)
Initial CD4 count, cells/mm3
<50 51,925 79 15.40 (11.10–21.38) 8.94 (6.26–12.77) <0.0001
51–199 181,448 113 8.11 (6.00–10.96) 4.63 (3.38–6.35) <0.0001
200–349 326,745 97 4.09 (3.00–5.58) 2.60 (1.88–3.58) <0.0001
350–500 406,760 52 1.78 (1.24–2.56) 1.36 (0.94–1.97) 0.10
>500
 948,770
 68
 Referent
 Referent
Initial viral load, copies/mm3
<20 1,069,688 94 Referent Referent 0.24
21–400 240,498 51 2.40 (1.70–3.37) 1.27 (0.84–1.93) 0.001
401–1,000 53,468 22 4.68 (2.94–7-44) 2.42 (1.40–4.17) 0.003
1,001–10,000 135,410 35 2.93 (1.99–4.33) 1.89 (1.23–2.91) 0.005
10,001–100,000 143,257 51 4.04 (2.87–5.69) 1.78 (1.18–2.67) <0.0001
>100,000 64,702 79 13.79 (10.22–18.61) 4.20 (2.88–6.13) <0.0001
Missing
 485,100
 221
 5.21 (4.08–6.66)
 3.26 (2.43–4.36)
Residence
Mainland France 1,889,675 150 Referent Referent <0.0001
Guadeloupe 44,325 34 9.35 (6.44–13.57) 12.15 (7.42–19.91) <0.0001
Martinique 27,112 17 7.69 (4.65–12.69) 11.95 (6.47–22.07) <0.0001
French Guiana 33,767 318 102.88 (84.64–125.06) 111.43 (79.18–156.82) 0.36
Reunion Island
 19,482
 2
 1.28 (0.31–5.16)
 1.90 (0.46–7.73)
Origin
France 1,437,390 166 Referent Referent 0.47
Western Europe 58,573 1 0.16 (0.02–1.15) 0.48 (0.06–3.50) NA
North America 5,414 1 1.67 (0.23–11.94) NA <0.0001
Central and South America 39,905 189 31.88 (25–70–39.54) 2.57 (1.84–3.58) 0.36
Caribbean 76,849 105 13.30 (10.38–17.03) 1.17 (0.82–1.65) <0.0001
Sub-Saharan Africa 435,761 83 2.00 (1.52–2.62) 4.52 (3.18–6.42) NA
Middle East 9,368 2 2.14 (0.53–8.66) NA <0.0001
Asia 30,572 6 1.99 (0.88–4.51) 5.50 (2.21–13.69) NA

*NA, not available. †Model stratified on age group (age categories are time-varying and violate hazard proportionality assumption); excluded by Stata (https://www.stata.com).

Main Article

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