Incidence and characteristics of candidemia in hospitalised patients with advanced HIV in the Médecins Sans Frontières (MSF) hospital in Kinshasa, Democratic Republic of Congo (DRC)

Candidemia is an underrecognised complication among patients with advanced HIV disease (AHD), particularly in low‑resource settings. We conducted a retrospective study at an MSF-supported hospital in Kinshasa (2022–2025) to describe the incidence, characteristics, and outcomes of candidemia. Among 3974 AHD admissions, 46 candidemia cases (1.2%) were identified, more than 80% of which were healthcare‑associated. Mortality was high (76.1%) and many deaths occurred before microbiological confirmation. Classical risk factors, such as indwelling catheters and parenteral nutrition, were uncommon, suggesting alternative pathogenic mechanisms. Findings highlight the need for improved diagnostics and access to antifungal susceptibility testing.