HIV and fungal priority pathogens

Article Authors: Hatim Sati, MD Ana Alastruey-Izquierdo, PhD Prof John Perfect, MD Prof Nelesh P Govender, FRCPath Prof Tom S Harrison, MD Tom Chiller, MD Prof Tania C Sorrell, MD[Res] Felix Bongomin, MBChB Rita Oladele, PhD Arunaloke Chakrabarti, MD Retno Wahyuningsih, MD Prof Arnaldo Lopes Colombo, MD Prof Juan Luis Rodriguez-Tudela, PhD Prof Chris Beyrer, MD Nathan Ford, DSc


The burden of invasive fungal infections associated with opportunistic fungal pathogens is a persistent challenge, particularly among people with advanced HIV disease. In October, 2022, WHO published the Fungal Priority Pathogens List (FPPL)-the first global effort to systematically prioritise fungal pathogens. Of the 19 pathogens in the WHO FPPL, four opportunistic pathogens in particular cause invasive diseases in people living with HIV: Cryptococcus neoformans, Histoplasma spp, Pneumocystis jirovecii, and Talaromyces marneffei. These four fungal pathogens are major causes of illness and death in people with advanced HIV and overwhelmingly affect those in low-income and middle-income countries. Access to diagnostics, improved surveillance, targeted support for innovation, and an enhanced public health focus on these diseases are needed in the effort to reduce HIV-associated deaths.

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Hatim Sati 1Ana Alastruey-Izquierdo 2John Perfect 3Nelesh P Govender 4Tom S Harrison 5Tom Chiller 6Tania C Sorrell 7Felix Bongomin 8Rita Oladele 9Arunaloke Chakrabarti 10Retno Wahyuningsih 11Arnaldo Lopes Colombo 12Juan Luis Rodriguez-Tudela 13Chris Beyrer 14Nathan Ford 15

1 Antimicrobial Resistance Division, WHO, Geneva, Switzerland.
2 Mycology Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain.
3 Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
4 National Institute for Communicable Diseases, Division of the National Health Laboratory Service, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; MRC Centre for Medical Mycology, University of Exeter, Exeter, UK.
5 Centre for Global Health, Institute of Infection and Immunity, St George’s University of London, London, UK; MRC Centre for Medical Mycology, University of Exeter, Exeter, UK.
6 Centers for Disease Control and Prevention, Atlanta, GA, USA.
7 Sydney Infectious Disease Institute, University of Sydney, Sydney, NSW, Australia.
8 Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.
9 Department of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria.
10 Doodhdhari Burfani Hospital and Research Institute, Haridwar, India.
11 Department of Parasitology, Universitas Indonesia and Universitas Kristen Indonesia, Indonesia.
12 Department of Medicine, Division of Infectious Diseases, Federal University of São Paulo, São Paulo, Brazil.
13 Global Action for Fungal Infections, Geneva, Switzerland.
14 Duke Global Health Institute, Duke University, Durham, NC, USA.
15 Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland; Centre for Infectious Disease and Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. Electronic address: