A 30-Year Epidemiological Study of Opportunistic Fungal Infections in People Living with HIV in Greece: Associations with Demographic Characteristics and Immune Status

Background/Objectives Opportunistic fungal infections are frequently observed in patients living with HIV and contribute significantly to morbidity, mortality, and hospitalization rates within this population. The aim of this study is to note the prevalence of dermatological manifestations related to fungal infections among HIV-positive patients and its correlation with demographic, other clinical characteristics and immune status of the participants. Methods A retrospective review was conducted on a cohort of 2,500 patients living with HIV that have been treated at the Infectious Diseases Unit of "Andreas Syggros" Hospital for Skin and Venereal Diseases from 1988 to 2017. Data from patients diagnosed with opportunistic fungal infections were analyzed. Patients were either antiretroviral therapy (ART)-naïve or already under treatment. Recorded fungal infections were correlated with epidemiological data and CD4+ cell counts. Results Opportunistic fungal infections were documented in 859 patients (34.36%), with a male predominance. Candidiasis was the most frequently reported condition, with higher prevalence among female patients. Lower CD4+ counts were significantly associated with increased risk of cryptococcal meningitis, esophageal candidiasis, Pneumocystis jirovecii pneumonia (PJP), and oral candidiasis, whereas higher CD4+ counts were observed in individuals with dermatophytosis, onychomycosis, and pityriasis/tinea versicolor. Conclusions Opportunistic fungal infections remain prevalent among HIV-positive individuals, particularly in immunocompromised patients. CD4+ cell counts serve as crucial diagnostic and prognostic markers for clinical outcomes in HIV patients, underscoring their role in disease monitoring and management.