Author:
Hoyos Pulgarin Julián Andrés,Alzate Piedrahita John Alexander,Moreno Gómez German Alberto,Sierra Palacio Juan Felipe,Ordoñez Karen Melissa,Arias Ramos Deving
Abstract
Abstract
Background
The HIV pandemic continues to cause a high burden of morbidity and mortality due to delayed diagnosis. Histoplasmosis is prevalent in Latin America and Colombia, is difficult to diagnose and has a high mortality. Here we determined the clinical characteristics and risk factors of histoplasmosis in people living with HIV (PLWH) in Pereira, Colombia.
Materials and methods
This was a retrospective cross-sectional study (2014–2019) involving two tertiary medical centers in Pereira, Colombia. People hospitalized with HIV were included. Histoplasma antigen detection was performed in urine samples. Probable histoplasmosis was defined according to European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group/National Institute of Allergy and Infectious Diseases Mycoses Study Group criteria.
Results
172 HIV-infected patients were analyzed. Histoplasmosis was confirmed in 29% (n = 50/172) of patients. The logistic regression analysis showed that the risk factors for histoplasmosis were pancytopenia (OR 4.1, 95% CI 1.6–10.3, P = 0.002), < 50 CD4 + cells/μL (OR 3.1, 95% CI 1.3–7.3, P = 0.006) and Aspartate transaminase (AST) levels > 46 IU/L (OR 3.2, 95% CI 1.3–8, P = 0.010).
Conclusions
Histoplasmosis is highly prevalent in hospitalized patients with HIV in Pereira, Colombia. The clinical findings are nonspecific, but there are some clinical abnormalities that can lead to suspicion of the disease, early diagnosis and prompt treatment. Urine antigen detection is useful for diagnosis, but is not widely available. An algorithmic approach is proposed for low-resource clinical settings.
Publisher
Springer Science and Business Media LLC
Subject
Pharmacology (medical),Virology,Molecular Medicine
Reference24 articles.
1. Colombo AL, Tobon A, Restrepo A, Queiroz-Telles F, Nucci M. Epidemiology of endemic systemic fungal infections in Latin America. Med Mycol. 2011;49(8):785–98.
2. Nacher M, Couppie P, Epelboin L, Djossou F, Demar M, Adenis A. Disseminated histoplasmosis: fighting a neglected killer of patients with advanced HIV disease in Latin America. PLoS Pathog. 2020;16(5): e1008449.
3. Adenis AA, Aznar C, Couppie P. Histoplasmosis in HIV-infected patients: a review of new developments and remaining gaps. Curr Trop Med Rep. 2014;1:119–28.
4. Arango M, Castañeda E, Agudelo CI, De Bedout C, Agudelo CA, Tobón A, et al. Histoplasmosis en Colombia: resultados de la encuesta nacional, 1992–2008. Biomedica. 1969;31(3):344–56.
5. Adenis A, Nacher M, Hanf M, Vantilcke V, Boukhari R, Blachet D, et al. HIV-associated histoplasmosis early mortality and incidence trends: from neglect to priority. PLoS Negl Trop Dis. 2014;8(8): e3100.
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献