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Disseminated histoplasmosis and AIDS: a prospective and multicentre study to evaluate the performance of different diagnostic tests.
Mycoses. 2017 Jan; 60(1):20-24.M

Abstract

The burden of histoplasmosis has been poorly documented in most of the endemic areas for the disease, including Brazil. Also, modern non-culture-based diagnostic tests are often non-available in these regions. This was a prospective cohort study in HIV-infected patients with suspected disseminated disease evaluated with different diagnostic tests. Patients were enrolled in three referral medical centres in Porto Alegre, Brazil. Among 78 evaluated patients, disseminated histoplasmosis was confirmed in eight individuals (10.3%) by the means of classical (culture/histopathology) tests. Antigen detection in the urine was found to be more sensitive: IMMY® ALPHA ELISA detected 13 positive cases (16.7%) and the in-house ELISA test developed by the Centers for Disease Prevention and Control (CDC) detected 14 (17.9%). IMMY® and CDC tests provided concordant results in 96.2% of cases. This is the first study to compare the performance of the in-house CDC ELISA test with the IMMY® commercial test for the diagnosis of histoplasmosis, and a high degree of concordance was observed. The study revealed that H. capsulatum is an important agent of disseminated disease in AIDS patients in Brazil, reinforcing the importance of making available modern diagnostic tests as well as safer antifungal agents for the treatment of histoplasmosis.

Authors+Show Affiliations

Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil. Universidade Federal do Piauí (UFPI), Teresina, Brazil.Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil. Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil.Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil. Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil. Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

27443422

Citation

Hoffmann, E R., et al. "Disseminated Histoplasmosis and AIDS: a Prospective and Multicentre Study to Evaluate the Performance of Different Diagnostic Tests." Mycoses, vol. 60, no. 1, 2017, pp. 20-24.
Hoffmann ER, Daboit TC, Paskulin DD, et al. Disseminated histoplasmosis and AIDS: a prospective and multicentre study to evaluate the performance of different diagnostic tests. Mycoses. 2017;60(1):20-24.
Hoffmann, E. R., Daboit, T. C., Paskulin, D. D., Monteiro, A. A., Falci, D. R., Linhares, T., Flores, J. M., Goldani, L. Z., de Melo, M. G., Behar, P. R., & Pasqualotto, A. C. (2017). Disseminated histoplasmosis and AIDS: a prospective and multicentre study to evaluate the performance of different diagnostic tests. Mycoses, 60(1), 20-24. https://doi.org/10.1111/myc.12536
Hoffmann ER, et al. Disseminated Histoplasmosis and AIDS: a Prospective and Multicentre Study to Evaluate the Performance of Different Diagnostic Tests. Mycoses. 2017;60(1):20-24. PubMed PMID: 27443422.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disseminated histoplasmosis and AIDS: a prospective and multicentre study to evaluate the performance of different diagnostic tests. AU - Hoffmann,E R, AU - Daboit,T C, AU - Paskulin,D D, AU - Monteiro,A A, AU - Falci,D R, AU - Linhares,T, AU - Flores,J M, AU - Goldani,L Z, AU - de Melo,M G, AU - Behar,P R, AU - Pasqualotto,A C, Y1 - 2016/07/22/ PY - 2016/05/15/received PY - 2016/06/22/revised PY - 2016/06/22/accepted PY - 2016/7/23/pubmed PY - 2018/7/27/medline PY - 2016/7/23/entrez KW - AIDS KW - Disseminated histoplasmosis KW - antigen detection KW - enzyme immunoassay KW - urine SP - 20 EP - 24 JF - Mycoses JO - Mycoses VL - 60 IS - 1 N2 - The burden of histoplasmosis has been poorly documented in most of the endemic areas for the disease, including Brazil. Also, modern non-culture-based diagnostic tests are often non-available in these regions. This was a prospective cohort study in HIV-infected patients with suspected disseminated disease evaluated with different diagnostic tests. Patients were enrolled in three referral medical centres in Porto Alegre, Brazil. Among 78 evaluated patients, disseminated histoplasmosis was confirmed in eight individuals (10.3%) by the means of classical (culture/histopathology) tests. Antigen detection in the urine was found to be more sensitive: IMMY® ALPHA ELISA detected 13 positive cases (16.7%) and the in-house ELISA test developed by the Centers for Disease Prevention and Control (CDC) detected 14 (17.9%). IMMY® and CDC tests provided concordant results in 96.2% of cases. This is the first study to compare the performance of the in-house CDC ELISA test with the IMMY® commercial test for the diagnosis of histoplasmosis, and a high degree of concordance was observed. The study revealed that H. capsulatum is an important agent of disseminated disease in AIDS patients in Brazil, reinforcing the importance of making available modern diagnostic tests as well as safer antifungal agents for the treatment of histoplasmosis. SN - 1439-0507 UR - https://www.unboundmedicine.com/medline/citation/27443422/Disseminated_histoplasmosis_and_AIDS:_a_prospective_and_multicentre_study_to_evaluate_the_performance_of_different_diagnostic_tests_ L2 - https://doi.org/10.1111/myc.12536 DB - PRIME DP - Unbound Medicine ER -