Multistate Epidemiology of Histoplasmosis, United States, 2011–2014<sup>1</sup>

Armstrong, Paige A.; Jackson, Brendan R; Haselow, Dirk; Fields, Virgie; Ireland, Malia; Austin, Connie; Signs, Kimberly; Fialkowski, Veronica; Patel, Reema; Ellis, Peggy; Iwen, Peter C.; Pedati, Caitlin; Gibbons-Burgener, Suzanne; Anderson, Jannifer; Dobbs, Thomas; Davidson, Sherri; McIntyre, Mary G.; Warren, Kimberly; Midla, Joanne; Luong, Nhiem; Benedict, Kaitlin

doi:10.3201/eid2403.171258

Cited by 89 publications

(99 citation statements)

References 19 publications

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“…This pattern could be influenced by greater provider awareness of POHS in known endemic areas, but it is unlikely to be completely explained by this phenomenon alone. In general, histoplasmosis is an under-recognized infection in the United States, [13] and information about its long-term sequelae, including POHS, is limited. We hope that that future experimental and epidemiologic studies can further clarify the relationship between Histoplasma and POHS.…”

Section: Plos Onementioning

confidence: 99%

“…Another notable demographic finding is the higher proportion of POHS in females, whereas previous studies have shown that POHS appears to affect males and females similarly [11] or have a slight predominance in males, similar to histoplasmosis in general. [6,13] These differences could be related to the convenience sample nature of MarketScan data or to differences in care-seeking behavior by sex. In contrast to prior reports, we did not find an association between smoking and CNV.…”

Section: Plos Onementioning

confidence: 99%

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Presumed ocular histoplasmosis syndrome in a commercially insured population, United States

et al. 2020

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To describe epidemiologic features of patients with presumed ocular histoplasmosis syndrome (POHS) in the United States using insurance claims data and compare POHS patients with and without choroidal neovascularization (CNV). Design Retrospective cohort study. Methods Patients with International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for histoplasmosis retinitis on an outpatient claim in the 2014 IBM ® Market-Scan ® Commercial Database and the Medicare Supplemental Database who were enrolled for at least 2 years after the POHS code. Main outcome measures Data related to testing, treatment, and direct medical costs. Results Among >50 million total MarketScan enrollees, 6,678 (13 per 100,000) had a POHS diagnosis code. Of those, 2,718 were enrolled for 2 years; 698 (25%) of whom had a CNV code. Eleven of the 13 states with the highest POHS rates bordered the Mississippi and Ohio rivers. CNV patients had significantly more eye care provider visits (mean 8.8 vs. 3.2, p<0.0001), more ophthalmic imaging tests, higher rates of treatment with anti-vascular endothelial growth factor injections (45% vs. 4%, p<0.0001), and incurred higher mean total yearly costs ($1,251.83 vs. $251.36, p<0.0001) than POHS patients without CNV.

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Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Presumed ocular histoplasmosis syndrome in a commercially insured population, United States

et al. 2020

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“…State-level incidence rates of histoplasmosis among older patients also demonstrate a shift toward Nebraska and the northern Great Lakes area ( 7 ). In addition, a recent publication of surveillance data from 2011 through 2014 in 12 states suggests that histoplasmosis also occurs in Minnesota, Wisconsin, and Michigan, areas where histoplasmosis was not thought to be endemic ( 8 ). …”

mentioning

confidence: 99%

MappingHistoplasma capsulatumExposure, United States

Maiga¹,

Deppen²,

Scaffidi³

et al. 2018

Emerg. Infect. Dis.

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Maps of Histoplasma capsulatum infection prevalence were created 50 years ago; since then, the environment, climate, and anthropogenic land use have changed drastically. Recent outbreaks of acute disease in Montana and Nebraska, USA, suggest shifts in geographic distribution, necessitating updated prevalence maps. To create a weighted overlay geographic suitability model for Histoplasma, we used a geographic information system to combine satellite imagery integrating land cover use (70%), distance to water (20%), and soil pH (10%). We used logistic regression modeling to compare our map with state-level histoplasmosis incidence data from a 5% sample from the Centers for Medicare and Medicaid Services. When compared with the state-based Centers data, the predictive accuracy of the suitability score–predicted states with high and mid-to-high histoplasmosis incidence was moderate. Preferred soil environments for Histoplasma have migrated into the upper Missouri River basin. Suitability score mapping may be applicable to other geographically specific infectious vectors.

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“…1b and Supplementary Tab. [1][2][3][4][5][6][7][8]. The most diverse subclasses of lipids in terms of number of identified lipids were triacylglycerols (TG), phosphatidylcholines (PC) and phosphatidylethanolamine (PE) with 130, 57 and 51 individual species, respectively (Fig.…”

Section: Proteomic and Lipidomic Analyses And Overview Of The H Capsmentioning

confidence: 99%

“…Histoplasma capsulatum, the causative agent of histoplasmosis, is an important pathogen in this context, being associated with HIV infections and a major cause of morbidity and mortality worldwide 2 . A 2018 CDC report, reviewed hospitalization data from 2011-2014 in only 12 states in the US and identified 3,409 cases of histoplasmosis with a 7% mortality rate 3 .…”

Section: Introductionmentioning

confidence: 99%

AHistoplasma capsulatumlipid metabolic map identifies antifungal targets

Zamith-Miranda

Heyman

Burnet

et al. 2020

Preprint

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Lipids play a fundamental role in fungal cell biology, being components of the cell membrane as well as targets of antifungal drugs. A deeper knowledge of lipid metabolism is key for developing new drugs and a better understanding of fungal pathogenesis. Here we built a comprehensive map of the Histoplasma capsulatum lipid metabolic pathway by integrating proteomic and lipidomic analyses. The map led to the identification of both the fatty acid desaturation and the sphingolipid biosynthesis pathways as targets for drug development. We also found that H. capsulatum produces analogs of platelet-activating factor, a potent regulator of the human immune response. The H. capsulatum platelet-activating factor analogs induced platelet aggregation and stimulated the production of the cytokines interleukin-10 and tumor necrosis factor-α by J774 macrophages. Overall, this lipid metabolic map revealed pathways that can be targeted for drug development, in addition to identifying a regulator of the host immune response. decrease in aged yeast cells 25 . In terms of sphingolipids, H. capsulatum also produces glucosylceramides, inositolphosphorylceramides and galactosyl-dimannosylinositolphosphorylceramides, which are components of membrane microdomains and are important for infection 20,26,27 . Considering the importance of lipids, we reasoned that a deeper characterization of H. capsulatum lipid metabolism would result in the discovery of virulence factors and drug targets. In this study, we performed an in-depth characterization of the H. capsulatum lipid biosynthetic pathway by profiling its lipids and the associated proteins, which were integrated into a metabolic map. By comparing our results to Saccharomyces cerevisiae and humans, we show unique features of the lipid biosynthetic pathway of H. capsulatum that can be targeted for drug development. This analysis also led to the discovery that H.capsulatum produces analogs of platelet-activating factor (PAF), which are biologically active and regulate different aspects of the human immune response.

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Multistate Epidemiology of Histoplasmosis, United States, 2011–2014¹

Abstract: Increased awareness could lead to appropriate diagnosis, prompt treatment, and better patient outcomes.

Cited by 89 publications

References 19 publications

Presumed ocular histoplasmosis syndrome in a commercially insured population, United States

Presumed ocular histoplasmosis syndrome in a commercially insured population, United States

MappingHistoplasma capsulatumExposure, United States

AHistoplasma capsulatumlipid metabolic map identifies antifungal targets

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Multistate Epidemiology of Histoplasmosis, United States, 2011–20141

Abstract: Increased awareness could lead to appropriate diagnosis, prompt treatment, and better patient outcomes.

Cited by 89 publications

References 19 publications

Presumed ocular histoplasmosis syndrome in a commercially insured population, United States

Presumed ocular histoplasmosis syndrome in a commercially insured population, United States

MappingHistoplasma capsulatumExposure, United States

AHistoplasma capsulatumlipid metabolic map identifies antifungal targets

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Product

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Multistate Epidemiology of Histoplasmosis, United States, 2011–2014¹