Background: Opportunistic fungal infections (OFIs) remain a significant cause of morbidity and mortality among patients with HIV/AIDS, particularly in resource-limited settings. Despite widespread antiretroviral therapy (ART), fungal infections such as candidiasis, cryptococcosis, and aspergillosis continue to pose clinical challenges. Objectives: To determine the spectrum, prevalence, and associated risk factors of opportunistic fungal infections among HIV/AIDS patients attending JLNMCH in Eastern India. Methods: A cross-sectional study was conducted among 150 HIV-positive patients. Clinical evaluation, CD4 count estimation, direct microscopy (KOH mount, India ink), culture, and fungal identification were performed. Statistical analysis was conducted using chi-square test and logistic regression. A p-value <0.05 was considered significant. Results: Out of 150 patients, 68 (45.3%) had confirmed fungal infections. Oropharyngeal candidiasis (26.7%) was the most common infection, followed by cryptococcosis (8.7%), dermatophytosis (5.3%), and aspergillosis (4.6%). A strong association was observed between CD4 count <200 cells/µL and occurrence of fungal infection (χ²=18.42, p<
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