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A multicenter evaluation of tests for diagnosis of histoplasmosis.
Clin Infect Dis. 2011 Sep; 53(5):448-54.CI

Abstract

BACKGROUND

The sensitivity of the MVista Histoplasma antigen enzyme immunoassay (MiraVista Diagnostics) has been evaluated in disseminated histoplasmosis in patients with AIDS and in the "epidemic" form of acute pneumonia. Moreover, there has been no evaluation of the sensitivity of antigenemia detection in disseminated histoplasmosis after the implementation of methods to dissociate immune complexes and denature released antibodies. The goal of this study was to determine the sensitivity of the current antigen assay in different categories of histoplasmosis.

METHODS

Urine and serum specimens obtained from 218 patients with histoplasmosis and 229 control subjects, including 30 with blastomycosis, were tested.

RESULTS

Antigenuria was detected in 91.8% of 158 patients with disseminated histoplasmosis, 83.3% of 6 patients with acute histoplasmosis, 30.4% of 46 patients with subacute histoplasmosis, and 87.5% of 8 patients with chronic pulmonary histoplasmosis; antigenemia was present in 100% of 31 tested cases of disseminated histoplasmosis. Among patients with disseminated cases, antigenuria was detected more often and at higher concentrations in immunocompromised patients and those with severe disease. Specificity was 99.0% for patients with nonfungal infections (n = 130) and in healthy subjects (n = 69), but cross-reactivity occurred in 90% of patients with blastomycosis.

CONCLUSIONS

The sensitivity of antigen detection in disseminated histoplasmosis is higher in immunocompromised patients than in immunocompetent patients and in patients with more severe illness. The sensitivity for detection of antigenemia is similar to that for antigenuria in disseminated infection.

Authors+Show Affiliations

Pulmonary-Critical Care Medicine, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana 46202, USA. chage@iupui.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21810734

Citation

Hage, Chadi A., et al. "A Multicenter Evaluation of Tests for Diagnosis of Histoplasmosis." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 53, no. 5, 2011, pp. 448-54.
Hage CA, Ribes JA, Wengenack NL, et al. A multicenter evaluation of tests for diagnosis of histoplasmosis. Clin Infect Dis. 2011;53(5):448-54.
Hage, C. A., Ribes, J. A., Wengenack, N. L., Baddour, L. M., Assi, M., McKinsey, D. S., Hammoud, K., Alapat, D., Babady, N. E., Parker, M., Fuller, D., Noor, A., Davis, T. E., Rodgers, M., Connolly, P. A., El Haddad, B., & Wheat, L. J. (2011). A multicenter evaluation of tests for diagnosis of histoplasmosis. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 53(5), 448-54. https://doi.org/10.1093/cid/cir435
Hage CA, et al. A Multicenter Evaluation of Tests for Diagnosis of Histoplasmosis. Clin Infect Dis. 2011;53(5):448-54. PubMed PMID: 21810734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A multicenter evaluation of tests for diagnosis of histoplasmosis. AU - Hage,Chadi A, AU - Ribes,Julie A, AU - Wengenack,Nancy L, AU - Baddour,Larry M, AU - Assi,Maha, AU - McKinsey,David S, AU - Hammoud,Kassem, AU - Alapat,Daisy, AU - Babady,N Esther, AU - Parker,Michelle, AU - Fuller,DeAnna, AU - Noor,Aliya, AU - Davis,Thomas E, AU - Rodgers,Mark, AU - Connolly,Patricia A, AU - El Haddad,Boutros, AU - Wheat,L Joseph, Y1 - 2011/08/02/ PY - 2011/8/4/entrez PY - 2011/8/4/pubmed PY - 2012/3/16/medline SP - 448 EP - 54 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 53 IS - 5 N2 - BACKGROUND: The sensitivity of the MVista Histoplasma antigen enzyme immunoassay (MiraVista Diagnostics) has been evaluated in disseminated histoplasmosis in patients with AIDS and in the "epidemic" form of acute pneumonia. Moreover, there has been no evaluation of the sensitivity of antigenemia detection in disseminated histoplasmosis after the implementation of methods to dissociate immune complexes and denature released antibodies. The goal of this study was to determine the sensitivity of the current antigen assay in different categories of histoplasmosis. METHODS: Urine and serum specimens obtained from 218 patients with histoplasmosis and 229 control subjects, including 30 with blastomycosis, were tested. RESULTS: Antigenuria was detected in 91.8% of 158 patients with disseminated histoplasmosis, 83.3% of 6 patients with acute histoplasmosis, 30.4% of 46 patients with subacute histoplasmosis, and 87.5% of 8 patients with chronic pulmonary histoplasmosis; antigenemia was present in 100% of 31 tested cases of disseminated histoplasmosis. Among patients with disseminated cases, antigenuria was detected more often and at higher concentrations in immunocompromised patients and those with severe disease. Specificity was 99.0% for patients with nonfungal infections (n = 130) and in healthy subjects (n = 69), but cross-reactivity occurred in 90% of patients with blastomycosis. CONCLUSIONS: The sensitivity of antigen detection in disseminated histoplasmosis is higher in immunocompromised patients than in immunocompetent patients and in patients with more severe illness. The sensitivity for detection of antigenemia is similar to that for antigenuria in disseminated infection. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/21810734/A_multicenter_evaluation_of_tests_for_diagnosis_of_histoplasmosis_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cir435 DB - PRIME DP - Unbound Medicine ER -