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A complementary tool for management of disseminated Histoplasma capsulatum var. capsulatum infections in AIDS patients.
Int J Med Microbiol 2014; 304(8):1062-5IJ

Abstract

In South America, disseminated histoplasmosis due to Histoplasma capsulatum var. capsulatum (H. capsulatum), is a severe and frequent opportunistic infection in AIDS patients. In areas outside the USA where specific-Histoplasma antigen detection is not available, the diagnosis is difficult. With the galactomannan antigen (GM) detection, a test commonly used for invasive aspergillosis diagnosis, there is a cross-reactivity with H. capsulatum that can be helpful for the diagnosis of histoplasmosis. The aim of this study was to evaluate the GM detection for the diagnosis of disseminated histoplasmosis in AIDS patients. The performance of the GM detection was evaluated with serum collected in French Guiana where H. capsulatum is highly endemic. Sera from AIDS patients with disseminated histoplasmosis occurring from 2002 to 2009 and from control HIV-positive patients without histoplasmosis were tested with the GM detection and Histoplasma-specific antibody detection (IEP). In 39 AIDS patients with proven disseminated histoplasmosis, the sensitivity of the Histoplasma IEP was only 35.9% and was linked to the TCD4+ lymphocyte level. For the GM detection, the sensitivity (Se) was 76.9% and specificity (Sp) was 100% with the recommended threshold for aspergillosis diagnosis (0.5). The test was more efficient with a threshold of 0.4 (Se: 0.82 [95% CI: 0.66-0.92], Sp: 1.00 [95% CI: 0.86-1.00], LR+: >10, LR-: 0.18). This study confirms that the GM detection can be a surrogate marker for the diagnosis of disseminated histoplasmosis in AIDS patients in endemic areas where Histoplasma EIA is not available.

Authors+Show Affiliations

Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; INSERM UMR1043/CNRS UMR5282/Université de Toulouse UPS, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse F-31300, France. Electronic address: iriart.x@chu-toulouse.fr.Laboratoire Hospitalier et Universitaire Parasitologie Mycologie, Centre Hospitalier de Cayenne, BP 6006, 97300 Cayenne, French Guiana.INSERM UMR1043/CNRS UMR5282/Université de Toulouse UPS, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse F-31300, France.Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; INSERM UMR1043/CNRS UMR5282/Université de Toulouse UPS, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse F-31300, France.Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.CIC-EC Antilles-Guyane, CIE 802 Inserm, Centre Hospitalier de Cayenne, BP 6006, 97300 Cayenne, French Guiana.Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.Laboratoire Hospitalier et Universitaire Parasitologie Mycologie, Centre Hospitalier de Cayenne, BP 6006, 97300 Cayenne, French Guiana; Equipe EA 3593 Épidémiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Campus Saint Denis, Cayenne, French Guiana.Laboratoire Hospitalier et Universitaire Parasitologie Mycologie, Centre Hospitalier de Cayenne, BP 6006, 97300 Cayenne, French Guiana; Equipe EA 3593 Épidémiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Campus Saint Denis, Cayenne, French Guiana.Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.Service de dermatologie, Centre Hospitalier de Cayenne, BP 6006, 97300 Cayenne, French Guiana; Equipe EA 3593 Épidémiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Campus Saint Denis, Cayenne, French Guiana.CIC-EC Antilles-Guyane, CIE 802 Inserm, Centre Hospitalier de Cayenne, BP 6006, 97300 Cayenne, French Guiana; Equipe EA 3593 Épidémiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Campus Saint Denis, Cayenne, French Guiana.Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; INSERM UMR1043/CNRS UMR5282/Université de Toulouse UPS, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse F-31300, France.Laboratoire Hospitalier et Universitaire Parasitologie Mycologie, Centre Hospitalier de Cayenne, BP 6006, 97300 Cayenne, French Guiana; Equipe EA 3593 Épidémiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Campus Saint Denis, Cayenne, French Guiana. Electronic address: christine.aznar1@wanadoo.fr.

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

25201327

Citation

Iriart, Xavier, et al. "A Complementary Tool for Management of Disseminated Histoplasma Capsulatum Var. Capsulatum Infections in AIDS Patients." International Journal of Medical Microbiology : IJMM, vol. 304, no. 8, 2014, pp. 1062-5.
Iriart X, Blanchet D, Menard S, et al. A complementary tool for management of disseminated Histoplasma capsulatum var. capsulatum infections in AIDS patients. Int J Med Microbiol. 2014;304(8):1062-5.
Iriart, X., Blanchet, D., Menard, S., Lavergne, R. A., Chauvin, P., Adenis, A., ... Aznar, C. (2014). A complementary tool for management of disseminated Histoplasma capsulatum var. capsulatum infections in AIDS patients. International Journal of Medical Microbiology : IJMM, 304(8), pp. 1062-5. doi:10.1016/j.ijmm.2014.07.016.
Iriart X, et al. A Complementary Tool for Management of Disseminated Histoplasma Capsulatum Var. Capsulatum Infections in AIDS Patients. Int J Med Microbiol. 2014;304(8):1062-5. PubMed PMID: 25201327.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A complementary tool for management of disseminated Histoplasma capsulatum var. capsulatum infections in AIDS patients. AU - Iriart,Xavier, AU - Blanchet,Denis, AU - Menard,Sandie, AU - Lavergne,Rose-Anne, AU - Chauvin,Pamela, AU - Adenis,Antoine, AU - Cassaing,Sophie, AU - Fillaux,Judith, AU - Magnaval,Jean-François, AU - Demar,Magalie, AU - Carme,Bernard, AU - Bessieres,Marie-Hélène, AU - Couppie,Pierre, AU - Nacher,Mathieu, AU - Berry,Antoine, AU - Aznar,Christine, Y1 - 2014/08/07/ PY - 2013/12/19/received PY - 2014/07/21/revised PY - 2014/07/28/accepted PY - 2014/9/10/entrez PY - 2014/9/10/pubmed PY - 2015/7/17/medline KW - AIDS KW - Antibody KW - Cross-reactivity KW - Diagnosis KW - Galactomannan KW - Histoplasma capsulatum KW - Histoplasmosis KW - Platelia SP - 1062 EP - 5 JF - International journal of medical microbiology : IJMM JO - Int. J. Med. Microbiol. VL - 304 IS - 8 N2 - In South America, disseminated histoplasmosis due to Histoplasma capsulatum var. capsulatum (H. capsulatum), is a severe and frequent opportunistic infection in AIDS patients. In areas outside the USA where specific-Histoplasma antigen detection is not available, the diagnosis is difficult. With the galactomannan antigen (GM) detection, a test commonly used for invasive aspergillosis diagnosis, there is a cross-reactivity with H. capsulatum that can be helpful for the diagnosis of histoplasmosis. The aim of this study was to evaluate the GM detection for the diagnosis of disseminated histoplasmosis in AIDS patients. The performance of the GM detection was evaluated with serum collected in French Guiana where H. capsulatum is highly endemic. Sera from AIDS patients with disseminated histoplasmosis occurring from 2002 to 2009 and from control HIV-positive patients without histoplasmosis were tested with the GM detection and Histoplasma-specific antibody detection (IEP). In 39 AIDS patients with proven disseminated histoplasmosis, the sensitivity of the Histoplasma IEP was only 35.9% and was linked to the TCD4+ lymphocyte level. For the GM detection, the sensitivity (Se) was 76.9% and specificity (Sp) was 100% with the recommended threshold for aspergillosis diagnosis (0.5). The test was more efficient with a threshold of 0.4 (Se: 0.82 [95% CI: 0.66-0.92], Sp: 1.00 [95% CI: 0.86-1.00], LR+: >10, LR-: 0.18). This study confirms that the GM detection can be a surrogate marker for the diagnosis of disseminated histoplasmosis in AIDS patients in endemic areas where Histoplasma EIA is not available. SN - 1618-0607 UR - https://www.unboundmedicine.com/medline/citation/25201327/A_complementary_tool_for_management_of_disseminated_Histoplasma_capsulatum_var__capsulatum_infections_in_AIDS_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1438-4221(14)00098-8 DB - PRIME DP - Unbound Medicine ER -