Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria

Oladele, Rita O.; Osaigbovo, Iriagbonse Iyabo; Adekanmbi, Olukemi; Ekeng, Bassey E.; Mohammed, Yahaya; Alex-Wele, M. A.; Okolo, Mark Ojogba; Ayanbeku, Stephen T; Unigwe, Uchechukwu S; Akase, Iorhen E.; Dan-Jumbo, Alali; Isralski, Dennis; Denning, David W.; Pasqualotto, Alessandro C.; Chiller, Tom

doi:10.3201/eid2811.220542

Cited by 29 publications

(18 citation statements)

References 24 publications

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“…It is thus not surprising that despite the increasing cases of DH, GIH is rarely reported. Underreporting is surprisingly pronounced in Africa, a region known to have documented several cases of DH [ 4 , 6 , 125 , 126 , 127 ]. An extensive review on histoplasmosis in Africa that spanned seven decades identified 470 cases of histoplasmosis, of which only one case was reported with GIH [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…An extensive review on histoplasmosis in Africa that spanned seven decades identified 470 cases of histoplasmosis, of which only one case was reported with GIH [ 5 ]. The paucity of data on GIH is first and foremost probably because histoplasmosis is still a neglected fungal disease in most parts of Africa, although with recent epidemiological studies, awareness is improving [ 125 , 126 , 127 ]. Recognition and reporting of GIH may also be hampered by a lack of adequate diagnostic procedures such as colonoscopy.…”

Section: Discussionmentioning

confidence: 99%

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Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Ekeng

Itam-Eyo

Osaigbovo

et al. 2023

Life

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Gastrointestinal histoplasmosis (GIH) is infrequently described in people without underlying HIV infection. We aimed to compare the clinical presentation of GIH in people with and without HIV infection. We conducted a literature search of published cases of GIH from 2001–2021 and found 212 cases. Of these, 142 (67.0%) were male, and 124 (58.5%) had HIV infection. Most cases were from North America (n = 88, 41.5%) and South America (n = 79, 37.3%). Of the 212 cases, 123 (58.0%) were included in both clinical and pathological analyses. The remainder were excluded as details about clinical and pathological findings were not available. Of the 123 cases, 41 had HIV infection while 82 were without HIV infection. The diagnosis was predominantly by histopathology (n = 109, 88.6%). A significant proportion of people with HIV infection had abdominal pain as the most predominant symptom of GIH compared to those without HIV infection (65.9% versus 41.9%, p < 0.05). The colon was the most affected site with a slightly higher proportion in those with HIV infection compared with cases without HIV infection (46.3% versus 42.7%). The commonest pathologic findings were caecal and ileal ulcers. Caecal ulcers were significantly more frequent in cases with HIV infection compared to those without HIV (32.1% versus 7.1%, p < 0.05). Despite being more common in people with HIV infection, GIH also affects people without HIV infection with similar clinical presentations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Ekeng

Itam-Eyo

Osaigbovo

et al. 2023

Life

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“…Occupational risk factors identified to be associated with histoplasmosis in AIDS-patients were working with birds [35] or history of exposure to chicken coops [40]. Among case patients who had worked with soil contaminated with chicken or bat droppings and who could recall the date of their most recent exposure, the median time from their last exposure to the onset of symptoms was of 1.6 years [35].…”

Section: Epidemiologymentioning

confidence: 99%

“…Several risk factors are associated with the progressive disseminated form: low CD4 lymphocytes count (less than 150) and low nadir CD4 count [40,42], low CD8 count [42], history of chronic medical condition and history of herpes simplex infection [35], and male gender [42]. Receiving treatment with TMP-SMZ was associated with a decreased risk of poor outcomes [35].…”

Section: Epidemiologymentioning

confidence: 99%

HIV-Associated Histoplasmosis

Cernat¹

2023

Infectious Diseases

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Impaired immunity induced by HIV is one of the main causes of disseminated histoplasmosis in endemic areas, and thus from 1987 WHO and then the CDC classified this condition as an AIDS-defining illness. Host factors associated independently with histoplasmosis are low level of CD4 (<150 cell/mm3) and CD8 count, low nadir CD4, male gender, the absence of cART, the absence of systemic antifungals, and history of herpes simplex infection. Dissemination of an exogenously new acquired infection or reinfection and reactivation of a latent infection are both described in HIV-infected patients. Also, inflammatory reconstitution disease following cART initiation is possible. Acute pulmonary infection is rare, and only in HIV-infected patients with CD4 > 200 cell/mm3. In advanced disease, the most frequent manifestation is as disseminated histoplasmosis often acute and severe, with complications such as respiratory failure, circulatory shock, and disseminated intravascular coagulation. The subacute presentation is frequent, associated with moderate involvement of the reticuloendothelial system, with great variability of clinical manifestation. Guidelines for diagnosing and managing histoplasmosis among people living with HIV have been published from WHO, IDSA, NIH, but limited data was based on randomized clinical trials.

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“…Pulmonary involvement is the most common form, since it is the site of primary infection. Disseminated forms are mainly described in immunocompromised subjects [ 2 , 7 , 8 ]. Natural reservoirs of conidia include bat guanos and bird droppings [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Acute pulmonary histoplasmosis of immunocompetent subjects from Martinique, Guadeloupe and French Guiana: a case series

et al. 2023

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Introduction Histoplasmosis is a fungal disease caused by Histoplasma capsulatum. Histoplasma capsulatum var capsulatum is found in Martinique. Cluster cases following working in deserted house, have been described in Martinique. Cases of acute pulmonary histoplasmosis have been described in immunosuppressed individuals, or in case of substantial exposure to reservoirs of Histoplasma capsulatum; however, cases of acute histoplasmosis are rare in immunocompetent individuals. Cases series We report a series of 4 cases of sporadic acute pulmonary histoplasmosis in immunocompetent subjects. Investigation revealed definite exposure in one patient and 3 cases with potential exposure. The diagnosis was microbiological and histological in 3 patients and histological in one patient. All subjects had positive serology to histoplasmosis. Pulmonary involvement was in the form of nodules and micronodules in 3 cases and ground glass lesions in one case. Patients were treated with itraconazole for 3 months and all had a favourable outcome. Conclusion We report a series of 4 cases of acute pulmonary histoplasmosis in immunocompetent individuals, occurring in a context where exposure was uncertain. This raises the problem of occult exposure in the Caribbean. Interventions to raise awareness and encourage caution are warranted targeting the population of the French West Indies and French Guiana.

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Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria

Cited by 29 publications

References 24 publications

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

HIV-Associated Histoplasmosis

Acute pulmonary histoplasmosis of immunocompetent subjects from Martinique, Guadeloupe and French Guiana: a case series

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