Risk Factors for Death in Acquired Immunodeficiency Syndrome–associated Disseminated Histoplasmosis

Daher, Elizabeth De Francesco; Barros, Fernando Antonio De Sousa; Silva, Geraldo Bezerra da; Takeda, Christianne Fernandes Valente; Mota, Rosa Maria Salani; Ferreira, Marúsia Thomaz; Martins, Julieta Cunha; Oliveira, Soraya Alves J Acinto; Gutiérrez-Adrianzén, Oswaldo A.

doi:10.4269/ajtmh.2006.74.600

Cited by 53 publications

(35 citation statements)

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“…5,8,21,22 Histoplasmosis is a common and important public health problem in these susceptible populations. [9][10][11][12][13][14][15][16][17][18][19][20] The aim of this study was to identify a clinical and laboratory profile associated with histoplasmosis in PLWHA that could allow early suspicion of the disease, reducing the time to diagnosis and thus the disease's high mortality rate.…”

Section: Introductionmentioning

confidence: 99%

“…8 In developing countries and in some regions of the United States that include resource-poor areas, high mortality rates are reported for PLWHA who have progressive disseminated histoplasmosis (PDH). [9][10][11][12][13][14][15][16][17][18][19][20] For these reasons, health-care providers should be aware of the incidence of histoplasmosis in Colombia, and consider the possibility of this diagnosis in PLWHA patients with clinically compatible illness.…”

Section: Introductionmentioning

confidence: 99%

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Clinical and Laboratory Profile of Persons Living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome and Histoplasmosis from a Colombian Hospital

Cáceres

Tobón

Cleveland

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Histoplasmosis is common among persons living with human immunodeficiency virus/acquired immune deficiency syndrome (PLWHA) in Latin America, but its diagnosis is difficult and often nonspecific. We conducted prospective screening for histoplasmosis among PLWHA with signs or symptoms suggesting progressive disseminated histoplasmosis (PDH) and hospitalized in Hospital La María in Medellín, Colombia. The study's aim was to obtain a clinical and laboratory profile of PLWHA with PDH. During 3 years (May 2008 to August 2011), we identified 89 PLWHA hospitalized with symptoms suggestive of PDH, of whom 45 (51%) had histoplasmosis. We observed tuberculosis (TB) coinfection in a large proportion of patients with PDH (35%), so all analyses were performed adjusting for this coinfection and, alternatively, excluding histoplasmosis patients with TB. Results showed that the patients with PDH were more likely to have Karnofsky score ≤ 30 (prevalence ratio [PR] = 1.98, 95% confidence interval [CI] = 0.97-4.06), liver compromised with hepatomegaly and/or splenomegaly (PR = 1.77, CI = 1.03-3.06) and elevation in serum of alanine aminotransferase and aspartate aminotransferase to values > 40 mU/mL (PR = 2.06, CI = 1.09-3.88 and PR = 1.53, CI = 0.99-2.35, respectively). Using multiple correspondence analyses, we identified in patients with PDH a profile characterized by the presence of constitutional symptoms, namely weight loss and Karnofsky classification ≤ 30, gastrointestinal manifestations with alteration of liver enzymes and hepatosplenomegaly and/or splenomegaly, skin lesions, and hematological alterations. Study of the profiles is no substitute for laboratory diagnostics, but identifying clinical and laboratory indicators of PLWHA with PDH should allow development of strategies for reducing the time to diagnosis and thus mortality caused by Histoplasma capsulatum.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical and Laboratory Profile of Persons Living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome and Histoplasmosis from a Colombian Hospital

Cáceres

Tobón

Cleveland

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…Asimismo, el problema engloba la dificultad para la sospecha clínica, tratamientos previos empíricos como tuberculosis (TBC), diagnóstico tardío por la falta de laboratorios implementados, diagnóstico tardío de la infección por VIH, retraso en el inicio del tratamiento antifúngico y no disponibilidad de formulaciones lipídicas de anfotericina B 1, [3][4][5][6] . Actualmente es considerada una enfermedad desatendida en Sudamérica 1,4,6 , y la mayoría de las series reportadas provienen de Brasil, Guayana Francesa, Colombia y Argentina [7][8][9][10][11] . En Perú no existen estudios ni series de casos que evalúen el comportamiento de la co-infección HD y VIH.…”

Section: Introductionunclassified

Histoplasmosis diseminada e infección por VIH: serie de casos en un hospital peruano

Pérez-Lazo

Maquera-Afaray

Mejía³

et al. 2017

Rev. chil. infectol.

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“…With the advent of AIDS in the 1980s and 90s, several cases of histoplasmosis were observed among patients with this syndrome. Currently, histoplasmosis is the most common systemic mycosis among HIV-infected individuals in endemic areas (de Francesco Daher et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the genetic diversity of Histoplasma capsulatum var. capsulatum isolates from north-eastern Brazil

Brilhante

Ribeiro

Lima

et al. 2012

Journal of Medical Microbiology

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Since the beginning of the HIV epidemic, there has been a significant increase in the number of histoplasmosis cases in Ceará , a state in north-east Brazil. The lack of epidemiological data on the genotypes circulating in the north-east region shows the importance of more detailed studies on the molecular epidemiology of Histoplasma capsulatum var. capsulatum in this region. Different molecular techniques have been used to better characterize the genetic profile of H. capsulatum var. capsulatum strains. The aim of this study was to analyse the genetic diversity of H. capsulatum var. capsulatum isolates in Fortaleza, the capital of Ceará , through the sequencing of the internal transcribed spacer (ITS)1-5.8S-ITS2 region, and establish the molecular profile of these isolates, along with strains from south-east Brazil, by RAPD analysis, featuring the different clusters in those regions. The isolates were grouped into two clusters. Cluster 1 included strains from the south-east and north-east regions with separation of isolates into three distinct subgroups (subgroups 1a, 1b and 1c). Cluster 2 included only samples from north-east Brazil. Sequencing of the ITS1-5.8S-ITS2 region allowed the detection of two major clades, which showed geographical correlation between them and their subgroups. Therefore, it can be concluded that the H. capsulatum var. capsulatum isolates from Ceará have a high degree of genetic polymorphism. The molecular data also confirm that populations of this fungus are composed of different genotypes in Brazil and worldwide. INTRODUCTIONHistoplasmosis is an important systemic mycosis, whose aetiological agent is the dimorphic fungus Histoplasma capsulatum. The natural habitat of this fungus is soil, where it grows as a filamentous saprophyte (Kauffman, 2009). This mycosis is widely distributed in the Americas, with a predominance of cases in some areas of the United States, such as along the valleys of the Mississippi and Ohio rivers, as well as in countries of Central and South America (Rossini & Goulart, 2006;Ferreira & Borges, 2009).In Brazil, the occurrence of histoplasmosis is relatively common, as demonstrated by the observation of autochthonous clinical cases, either in isolated cases or in the Abbreviations: ITS, internal transcribed spacer; UPGMA, unweighted pair group analysis with arithmetic mean.The GenBank/EMBL/DDBJ accession numbers for the ITS1-5.8S-ITS2 region sequences of strains used in this study are given in Table 1. Extraction of genomic DNA. Genomic DNA was extracted from yeast-phase cultures of the micro-organism grown for 5 days at 35 uC in Sabouraud agar (Himedia) supplemented with 10 % sheep's blood. DNA extraction was performed as described by Ausubel et al. (2002). Genomic DNA was extracted by mechanical lysis with glass beads and chemistry lysis using a breaking buffer. The nucleic acids were precipitated with ethanol after exposure to a solution of phenol/ chloroform/isoamyl alcohol to separate the cellular debris. The DNA pellet was then resuspended in TE buffer an...

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Risk Factors for Death in Acquired Immunodeficiency Syndrome–associated Disseminated Histoplasmosis

Cited by 53 publications

References 14 publications

Clinical and Laboratory Profile of Persons Living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome and Histoplasmosis from a Colombian Hospital

Clinical and Laboratory Profile of Persons Living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome and Histoplasmosis from a Colombian Hospital

Histoplasmosis diseminada e infección por VIH: serie de casos en un hospital peruano

Evaluation of the genetic diversity of Histoplasma capsulatum var. capsulatum isolates from north-eastern Brazil

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