Mucosal and invasive fungal infections in HIV/AIDS.

Advances in the management of fungal infections in AIDS justify this review. First, their incidence has fallen with the introduction of potent antiretroviral therapy. Now, most cases occur in patients with advanced HIV disease who have failed multiple antiretroviral regimens, are nonadherent to therapy, or treatment na ve. Immune reconstitution has reduced the incidence of these infections and permitted discontinuation of maintenance therapy. However, the immune response to antiretroviral therapy has resulted in paradoxical worsening in some cases, "so-called immune reconstitution inflammatory syndromes". Finally, new antifungal agents expand our treatment choices. This review updates management of fungal infections in AIDS.