Accuracy of Buffy Coat in the Diagnosis of Disseminated Histoplasmosis in AIDS-Patients in an Endemic Area of Brazil

Leitão, Terezinha do Menino Jesus Silva; Filho, Antônio Martins; Filho, José Evaldo P Sousa; Tavares, Bruno de Melo; Mesquita, Jacó Ricarte Lima de; Farias, Luís Arthur Brasil Gadelha; Mota, Rosa Salani; Damasceno, Lisandra Serra

doi:10.3390/jof5020047

Cited by 9 publications

(8 citation statements)

References 24 publications

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“…The GDG recommended complementary testing using microscopic analysis of the buffy coat, histopathological analysis, culture, and antibody or DNA detection in patients with clinical forms of histoplasmosis different to the disseminated disease [ 16 , 19 ].…”

Section: Resultsmentioning

confidence: 99%

Summary of Guidelines for Managing Histoplasmosis among People Living with HIV

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Cáceres

Ford

et al. 2021

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Histoplasmosis is a frequent fungal opportunistic infection in people living with HIV (PLHIV), associated every year to a total of 5% to 15% of AIDS-related deaths among this population. In 2020, the first global guidelines for diagnosing and managing disseminated histoplasmosis among PLHIV was published. This document recommends (1) detection of circulating Histoplasma antigens as the recommended laboratory assay to diagnose histoplasmosis among PLHIV; (2) the use of liposomal amphotericin for induction therapy in severe or moderately severe disease, followed by a maintenance therapy with itraconazole for 12 months; a shorter maintenance therapy could be considered if the patient is clinically stable and if immune status has improved; (3) antiretroviral therapy initiation as soon as possible among patients with histoplasmosis without involvement of central nervous system; and (4) that for the treatment of co-infection with histoplasmosis and tuberculosis (TB), treatment of TB should be initiated according to the World Health Organization treatment guidelines. Appropriate health education of providers, supportive supervision, and policy guidance for the care of PLHIV are required.

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Section: Resultsmentioning

confidence: 99%

Summary of Guidelines for Managing Histoplasmosis among People Living with HIV

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Cáceres

Ford

et al. 2021

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“…Colombia and French Guiana presented similar numbers of patients, n = 510 and n = 506, respectively (Table 2) [37,38,. In most of these reports, the cases were diagnosed by conventional laboratory tests, microscopy/histopathology, and culture (26 of 35 studies; 74%) [37,38,50,52,[55][56][57][58][59][60][61][62][63][64][65][66][67][71][72][73][74][76][77][78][79][80]. Studies that used Histoplasma Ag testing in urine, n = 9, were mostly conducted after 2014 [51,53,54,[68][69][70]74,75,81].…”

Section: Histoplasmosis In Plhiv In Latin Americamentioning

confidence: 99%

Tackling Histoplasmosis Infection in People Living with HIV from Latin America: From Diagnostic Strategy to Public Health Solutions

Cáceres

Gómez

Tobón

et al. 2023

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Histoplasmosis, caused by the thermally dimorphic fungus Histoplasma spp., is a disease with a broad clinical spectrum, presenting from asymptomatic/flu-like symptoms to progressive disseminated disease in people with immunosuppression. In recent years, the concept of histoplasmosis as a disease restricted to the American continent has changed, as now histoplasmosis is reported in many regions around the world. In Latin America, histoplasmosis represents a threat, especially in people with advanced HIV disease (AHD). Diagnosis of histoplasmosis in people living with HIV (PLHIV) is challenging due to the low index of suspicion of the disease, non-specificity of signs and symptoms, and limited access to specific laboratory testing, while the diagnostic delay is significantly associated with mortality. In the last decade, novel diagnostic tests have been developed for the rapid detection of histoplasmosis, such as commercial kits for antigen detection. Furthermore, advocacy groups were created that presented histoplasmosis as a public health problem, with emphasis on patients at risk of progressive disseminated disease. This review aims to discuss the impact of histoplasmosis associated with AHD in Latin America and the strategies employed to tackle histoplasmosis, from the implementation of laboratory testing to disease advocacy and public health interventions.

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“…According to Leitao et al , stained smears of buffy coat have low accuracy (26%); nonetheless, they are easy to perform and can give a quick diagnosis in low-resource endemic areas and reduce mortality. 43…”

Section: Introductionmentioning

confidence: 99%

Progressive disseminated histoplasmosis in HIV-positive patients

et al. 2022

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Background: Histoplasmosis is the most common endemic mycosis among people living with advanced HIV infection. Purpose: Describe general aspects and challenges of this disease and its association with HIV. Research Design: Review of literature. Study Sample: Articles found using different combinations of terms including “disseminated histoplasmosis” and AIDS/HIV or immunosuppression in PubMed, Scopus, WHO Global health library, and Scielo database. Analysis: We look for information on epidemiology, pathogenesis, diagnosis, and treatment of histoplasmosis in AIDS patients. Results: Histoplasmosis is caused by Histoplasma capsulatum, a dimorphic fungus encountered throughout the world, mainly in soil enriched with bat and bird excreta. Progressive disseminated histoplasmosis is the main presentation of this mycosis in people living with advanced HIV and is fatal if left untreated. Symptoms include a systemic disease characterized by fever, weight loss, night sweats, skin manifestations, hepatomegaly, splenomegaly, and septic shock. Diagnostic tests include culture, visualization of H. capsulatum by direct and histopathological examination, serology, antigen, molecular, and skin testing. Patients with disseminated disease require aggressive and prolonged treatment to eradicate the pathogen and include amphotericin B and itraconazole. In many low income countries of endemic regions, histoplasmosis in HIV-positive patients is often undiagnosed or misdiagnosed as another opportunistic infection, due to the similarity in clinical manifestations and to the paucity of better diagnostic tests. Conclusion: Histoplasmosis remains a neglected disease. Few studies about the disease and expensive treatments make it difficult to reduce the morbidity and mortality of this condition. Public health services and physicians must be aware of histoplasmosis' burden among the HIV-positive population.

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Accuracy of Buffy Coat in the Diagnosis of Disseminated Histoplasmosis in AIDS-Patients in an Endemic Area of Brazil

Cited by 9 publications

References 24 publications

Summary of Guidelines for Managing Histoplasmosis among People Living with HIV

Summary of Guidelines for Managing Histoplasmosis among People Living with HIV

Tackling Histoplasmosis Infection in People Living with HIV from Latin America: From Diagnostic Strategy to Public Health Solutions

Progressive disseminated histoplasmosis in HIV-positive patients

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