scholarly journals Multicenter Validation of Commercial Antigenuria Reagents To Diagnose Progressive Disseminated Histoplasmosis in People Living with HIV/AIDS in Two Latin American Countries

2018 ◽  
Vol 56 (6) ◽  
Author(s):  
Diego H. Cáceres ◽  
Blanca E. Samayoa ◽  
Narda G. Medina ◽  
Angela M. Tobón ◽  
Brenda J. Guzmán ◽  
...  
Keyword(s):  
Latin American ◽  
Histoplasma Capsulatum ◽  
Enzyme Linked Immunosorbent Assay ◽  
People Living With Hiv ◽  
Content Type ◽  
Disseminated Histoplasmosis ◽  
Wide Range ◽  
Progressive Disseminated Histoplasmosis ◽  
Living With Hiv ◽  
Hiv Aids

ABSTRACTHistoplasmosis is an important cause of mortality in patients with AIDS, especially in countries with limited access to antiretroviral therapies and diagnostic tests. However, many disseminated infections in Latin America go undiagnosed. A simple, rapid method to detectHistoplasma capsulatuminfection in regions where histoplasmosis is endemic would dramatically decrease the time to diagnosis and treatment, reducing morbidity and mortality. The aim of this study was to validate a commercial monoclonalHistoplasmagalactomannan (HGM) enzyme-linked immunosorbent assay (Immuno-Mycologics [IMMY], Norman, OK, USA) in two cohorts of people living with HIV/AIDS (PLHIV). We analyzed urine samples from 589 people (466 from Guatemala and 123 from Colombia), including 546 from PLHIV and 43 from non-PLHIV controls. Sixty-three of these people (35 from Guatemala and 28 from Colombia) had confirmed histoplasmosis by isolation ofH. capsulatum. Using the standard curve provided by the quantitative commercial test, the sensitivity was 98% (95% confidence interval [CI], 95 to 100%) and the specificity was 97% (95% CI, 96 to 99%) (cutoff = 0.5 ng/ml). Semiquantitative results, using a calibrator of 12.5 ng/ml ofHistoplasmagalactomannan to calculate an enzyme immunoassay index value (EIV) for the samples, showed a sensitivity of 95% (95% CI, 89 to 100%) and a specificity of 98% (95% CI, 96 to 99%) (cutoff ≥ 2.6 EIV). This relatively simple-to-perform commercial antigenuria test showed a high performance with reproducible results in both countries, suggesting that it can be used to detect progressive disseminated histoplasmosis in PLHIV in a wide range of clinical laboratories in countries where histoplasmosis is endemic.

scholarly journals Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

2021 ◽  
Vol 7 (6) ◽  
pp. 481
Author(s):  
Spinello Antinori ◽  
Andrea Giacomelli ◽  
Mario Corbellino ◽  
Alessandro Torre ◽  
Marco Schiuma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Infection ◽  
Histoplasma Capsulatum ◽  
People Living With Hiv ◽  
Immunocompromised Patients ◽  
Dimorphic Fungus ◽  
Endemic Region ◽  
Disseminated Histoplasmosis ◽  
Progressive Disseminated Histoplasmosis ◽  
Living With Hiv

Human histoplasmosis is a mycosis caused by two distinct varieties of a dimorphic fungus: Histoplasma capsulatum var. capsulatum and H. capsulatum var. duboisii. In Europe, it is usually imported by migrants and travellers, although there have been some autochthonous cases, especially in Italy; however, most European physicians are unfamiliar with its clinical and pathological picture, particularly among immunocompromised patients without HIV infection. This systematic review of all the cases of histoplasmosis reported in Europe and Israel between 2005 and 2020 identified 728 cases diagnosed in 17 European countries and Israel described in 133 articles. The vast majority were imported (mainly from Central and South America), but there were also seven autochthonous cases (six in Europe and one in Israel). The patients were prevalently males (60.4%), and their ages ranged from 2 to 86 years. The time between leaving an endemic region and the diagnosis of histoplasmosis varied from a few weeks to more than 40 years. Progressive disseminated histoplasmosis was the most frequent clinical picture among people living with HIV infection (89.5%) or a different immunocompromising condition (57.1%), but it was also recorded in 6.2% of immunocompetent patients. Twenty-eight cases were caused by Histoplasma duboisii. Immunocompromised patients without HIV infection had the worst outcomes, with a mortality rate of 32%.

scholarly journals Detection of Histoplasma capsulatum Antigen in Panamanian Patients with Disseminated Histoplasmosis and AIDS

2008 ◽  
Vol 15 (4) ◽  
pp. 681-683 ◽  
Author(s):  
Maria Eugenia Gutierrez ◽  
Alfredo Canton ◽  
Patricia Connolly ◽  
Robert Zarnowski ◽  
L. Joseph Wheat
Keyword(s):  
United States ◽  
Latin American ◽  
Histoplasma Capsulatum ◽  
Severe Disease ◽  
Nuclear Gene ◽  
The United States ◽  
Antigen Detection ◽  
Disseminated Histoplasmosis ◽  
Antigen Assay ◽  
Progressive Disseminated Histoplasmosis

ABSTRACT Histoplasmosis is a common endemic mycosis in the Americas, often causing severe disease in patients with AIDS. Antigen detection has become an important method for rapid diagnosis of histoplasmosis in the United States but not in Central or South America. Isolates from patients in the United States are predominantly found to be class 2 isolates when typed using the nuclear gene YPS3, while isolates from Latin America are predominantly typed as class 5 or class 6. Whether infection with these Latin American genotypes produces positive results in the Histoplasma antigen assay has not been reported. In this study, we have compared the sensitivity of antigen detection for AIDS patients from Panama who had progressive disseminated histoplasmosis to that for those in the United States. Antigenuria was detected in the MVista Histoplasma antigen enzyme immunoassay (EIA) in 95.2% of Panamanian cases versus 100% of U.S. cases. Antigenemia was detected in 94.7% of the Panamanian cases versus 92% of the U.S. cases. Two clinical isolates from Panama were typed using YPS3 and were found to be restriction fragment length polymorphism class 6. We conclude that the MVista Histoplasma antigen EIA is a sensitive method for diagnosis of histoplasmosis in Panama.

Complementary medicine use among people living with HIV/AIDS in Victoria, Australia: practices, attitudes and perceptions

2007 ◽  
Vol 18 (7) ◽  
pp. 453-457 ◽  
Author(s):  
S L Thomas ◽  
K Lam ◽  
L Piterman ◽  
A Mijch ◽  
P A Komesaroff
Keyword(s):  
Complementary Medicine ◽  
Conventional Medicine ◽  
People Living With Hiv ◽  
Attitudes And Beliefs ◽  
Limited Evidence ◽  
Alternative Medicines ◽  
Wide Range ◽  
Alfred Hospital ◽  
Living With Hiv ◽  
Hiv Aids

There is limited evidence suggesting the underlying reasons for the use of complementary and alternative medicines (CAMs) by people with HIV/AIDS, or individual attitudes and beliefs about the use of CAMs. Using focus groups and a survey with 151 individuals attending the HIV Clinics at The Alfred Hospital, Melbourne, we aimed to provide insights into factors that influence the use of CAMs among people living with HIV/AIDS. Roughly half (49%) of the participants had used CAMs to manage their HIV/AIDs. Users of CAMs utilized a wide range of treatments in managing their condition, but costs of the CAMs meant that users were not necessarily able to use them as much as they might have liked. Use of CAMs was based on a desire to find something beneficial rather than on being dissatisfied with conventional medicine. Further research is needed into (a) the effects of CAMs and (b) the enhancement of communication and collaboration between patients, doctors and complementary medicine practitioners.

scholarly journals Diagnostic accuracy of antigen detection in urine and molecular assays testing in different clinical samples for the diagnosis of progressive disseminated histoplasmosis in patients living with HIV/AIDS: A prospective multicenter study in Mexico

2021 ◽  
Vol 15 (3) ◽  
pp. e0009215
Author(s):  
Areli Martínez-Gamboa ◽  
María Dolores Niembro-Ortega ◽  
Pedro Torres-González ◽  
Janeth Santiago-Cruz ◽  
Nancy Guadalupe Velázquez-Zavala ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Diagnostic Accuracy ◽  
Nested Pcr ◽  
Urine Samples ◽  
People Living With Hiv ◽  
Bone Marrow Tissue ◽  
Disseminated Histoplasmosis ◽  
Progressive Disseminated Histoplasmosis ◽  
Sensitivity Specificity ◽  
Living With Hiv

Background The progressive disseminated histoplasmosis (PDH) has been associated with severe disease and high risk of death among people living with HIV (PLWHIV). Therefore, the purpose of this multicenter, prospective, double-blinded study done in ten Mexican hospitals was to determine the diagnostic accuracy of detecting Histoplasma capsulatum antigen in urine using the IMMY ALPHA Histoplasma EIA kit (IAHE), clarus Histoplasma GM Enzyme Immunoassay (cHGEI IMMY) and MiraVista Histoplasma Urine Antigen LFA (MVHUALFA); as well as the Hcp100 and 1281-1283220SCAR nested PCRs in blood, bone-marrow, tissue biopsies and urine. Methodology/Principal findings We included 415 PLWHIV older than 18 years of age with suspicion of PDH. Using as diagnostic standard recovery of H. capsulatum in blood, bone marrow or tissue cultures, or histopathological exam compatible, detected 108 patients (26%, [95%CI, 21.78–30.22]) with proven-PDH. We analyzed 391 urine samples by the IAHE, cHGEI IMMY and MVHUALFA; the sensitivity/specificity values obtained were 67.3% (95% CI, 57.4–76.2) / 96.2% (95% CI, 93.2–98.0) for IAHE, 91.3% (95% CI, 84.2–96.0) / 90.9% (95% CI, 87.0–94.0) for cHGEI IMMY and 90.4% (95% CI, 83.0–95.3) / 92.3% (95% CI, 88.6–95.1) for MVHUALFA. The Hcp100 nested PCR was performed on 393, 343, 75 and 297, blood, bone marrow, tissue and urine samples respectively; the sensitivity/specificity values obtained were 62.9% (95%CI, 53.3–72.5)/ 89.5% (95%CI, 86.0–93.0), 65.9% (95%CI, 56.0–75.8)/ 89.0% (95%CI, 85.2–92.9), 62.1% (95%CI, 44.4–79.7)/ 82.6% (95%CI, 71.7–93.6) and 34.9% (95%CI, 24.8–46.2)/ 67.3% (95%CI, 60.6–73.5) respectively; and 1281-1283220SCAR nested PCR was performed on 392, 344, 75 and 291, respectively; the sensitivity/specificity values obtained were 65.3% (95% CI, 55.9–74.7)/ 58.8% (95%CI, 53.2–64.5), 70.8% (95%CI, 61.3–80.2)/ 52.9% (95%CI, 46.8–59.1), 71.4% (95%CI, 54.7–88.2)/ 40.4% (95%CI, 26.4–54.5) and 18.1% (95%CI, 10.5–28.1)/ 90.4% (95%CI, 85.5–94.0), respectively. Conclusions/Significance The cHGEI IMMY and MVHUALFA tests showed excellent performance for the diagnosis of PDH in PLWHIV. The integration of these tests in clinical laboratories will certainly impact on early diagnosis and treatment.

Nutritional and health status of people living with HIV/AIDS in the eastern region of Ghana

2019 ◽  
Vol 50 (4) ◽  
pp. 765-783
Author(s):  
Francis Kwotua Apungu ◽  
Charles Apprey ◽  
Emmanuel Kobla Atsu Amewu ◽  
Samuel Terkper Ahuno ◽  
Alexander Kwarteng
Keyword(s):  
Viral Load ◽  
Health Status ◽  
Nutritional Status ◽  
Dietary Intake ◽  
High Viral Load ◽  
People Living With Hiv ◽  
Eastern Region ◽  
Content Type ◽  
Living With Hiv ◽  
Hiv Aids

Purpose The purpose of the study is to assess the nutritional and health status of people living with HIV/AIDS (18-60 years) in selected health facilities in the eastern region of Ghana and to determine the influence nutrition support programmes (NSP) have on the nutritional and health status of people living with HIV/AIDS. Design/methodology/approach A retrospective study design was used. Purposive and convenience sampling was used to select four hospitals and 200 beneficiaries and non-beneficiaries of the NSP. A structured questionnaire was used to collect the sociodemographic, anthropometric, biochemical and clinical history of the participants. Dietary intake was assessed with food frequency and 24-h dietary intake questionnaires. Previous data from the medical record within three to six months before the research was collected and compared with current data. Findings The prevalence of underweight (using body mass index) was 17 per cent and overweight/obesity was 37 per cent. Most respondents had adequate consumption of phosphorus (70.5 per cent); inadequate intake of calcium (95 per cent), vitamin E (77.5 per cent) and vitamin A (94 per cent); and excess intakes of sodium (93 per cent), selenium (77 per cent), copper (83.5 per cent) and manganese (76 per cent). There was no significant difference in nutrient intake of beneficiaries and non-beneficiaries of the NSP, although there were significant differences in the frequency of consumption of fruits (p < 0.001), vegetables (p < 0.001), legumes (p = 0.002), animal foods (p < 0.001) and cereals, grains and starch (p < 0.001) between beneficiaries and non-beneficiaries of NSP. About 38 and 20 per cent of respondents, respectively, had low haemoglobin (Hb < 11 g/dL) and high viral load (1,000 cp/mL). Comparing the current and previous (three to six months before the study) health and nutritional status of beneficiaries and non-beneficiaries of NSP, among the beneficiaries of NSP, monocytes increased by 40.6 per cent (p = 0.028) and mean weight decreased by 2.4 per cent (p = 0.007), Hb decreased by 7.1 per cent (p = 0.27) and viral load decreased by 4.2 per cent (p = 0.49), whereas among the non-beneficiaries, mean weight decreased by 0.05 per cent (p = 0.95) and Hb increased by 9.6 per cent (p = 0.06) and monocytes increased (p = 0.28) and viral load increased by 98.2 per cent (p = 0.34). Research limitations/implications A significant proportion of people living with HIV/AIDS had a high prevalence of underweight and overweight/obesity, inadequate nutrients intake and high viral load. The NSP for people living with HIV/AIDS in the eastern region of Ghana did not significantly influence the nutritional and health status of these people. Practical implications Knowing the nutritional status will help health institutions plan activities towards improving the health and nutritional status of people living with HIV/AIDS. This research is aimed at not only contributing to the existing body of knowledge but also making recommendations of action towards improving NSPs of people living with HIV/AIDS. Social implications Improvement in nutritional and health status of people living with HIV/AIDS will help reduce morbidity and mortality and its related cost to families, communities and the nation. Originality/value This study is first to determine the influence of NSPs on nutritional and health status of people living with HIV/AIDS in the eastern region of Ghana.

scholarly journals Patterns of Co-occurring Comorbidities in People Living With HIV

2018 ◽  
Vol 5 (11) ◽  
Author(s):  
Davide De Francesco ◽  
Sebastiaan O Verboeket ◽  
Jonathan Underwood ◽  
Emmanouil Bagkeris ◽  
Ferdinand W Wit ◽  
...  
Keyword(s):  
Mental Health ◽  
General Health ◽  
Mental Health Problems ◽  
Principal Component ◽  
The Other ◽  
People Living With Hiv ◽  
Wide Range ◽  
Living With Hiv ◽  
Shared Risk ◽  
Hiv Aids

Abstract Background The aims of this study were to identify common patterns of comorbidities observed in people living with HIV (PLWH), using a data-driven approach, and evaluate associations between patterns identified. Methods A wide range of comorbidities were assessed in PLWH participating in 2 independent cohorts (POPPY: UK/Ireland; AGEhIV: Netherlands). The presence/absence of each comorbidity was determined using a mix of self-reported medical history, concomitant medications, health care resource use, and laboratory parameters. Principal component analysis (PCA) based on Somers’ D statistic was applied to identify patterns of comorbidities. Results PCA identified 6 patterns among the 1073 POPPY PLWH (85.2% male; median age [interquartile range {IQR}], 52 [47–59] years): cardiovascular diseases (CVDs), sexually transmitted diseases (STDs), mental health problems, cancers, metabolic disorders, chest/other infections. The CVDs pattern was positively associated with cancer (r = .32), metabolic disorder (r = .38), mental health (r = .16), and chest/other infection (r = .17) patterns (all P &lt; .001). The mental health pattern was correlated with all the other patterns (in particular cancers: r = .20; chest/other infections: r = .27; both P &lt; .001). In the 598 AGEhIV PLWH (87.6% male; median age [IQR], 53 [48–59] years), 6 patterns were identified: CVDs, chest/liver, HIV/AIDS events, mental health/neurological problems, STDs, and general health. The general health pattern was correlated with all the other patterns (in particular CVDs: r = .14; chest/liver: r = .15; HIV/AIDS events: r = .31; all P &lt; .001), except STDs (r = –.02; P = .64). Conclusions Comorbidities in PLWH tend to occur in nonrandom patterns, reflecting known pathological mechanisms and shared risk factors, but also suggesting potential previously unknown mechanisms. Their identification may assist in adequately addressing the pathophysiology of increasingly prevalent multimorbidity in PLWH.

scholarly journals Trends and Determinants of Attitudes Towards People Living with HIV/AIDS Among Women of Reproductive Age in Tajikistan

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Hakim Zainiddinov
Keyword(s):  
Low Income ◽  
Representative Sample ◽  
Aids Prevention ◽  
Reproductive Age ◽  
People Living With Hiv ◽  
Women Of Reproductive Age ◽  
Wide Range ◽  
Prevention Methods ◽  
Living With Hiv ◽  
Hiv Aids

Introduction: Despite having one of lowest rates of newly diagnosed HIV infections among former Soviet countries, Tajikistan has a substantial level of discriminatory attitudes towards people living with HIV/AIDS (PLWHA). While initial attempts were made to explore discriminatory attitudes of a wide range of professionals, women’s general attitudes towards PLWHA received less scholarly attention. Employing a nationally representative sample from the 2000 and 2005 Multiple Indicator Cluster Surveys (MICS), sociodemographic determinants of HIV-related discriminatory attitudes of women aged 15-49 in Tajikistan were identified and examined over time.Methods:  A representative sample included 5,453 women of reproductive age from the capital city and four regions of Tajikistan. Two dichotomized scenarios  representing the agreement to let an HIV-infected teacher continue teaching in school and the willingness to buy food from an HIV-infected cashier were constructed. Univariate and multivariable analyses of HIV-related discriminatory attitudes were obtained using Stata 14.Results: Insignificant but positive changes were observed in the women’s attitudes between 2000 and 2005. Logistic regression models showed that negative attitudes were associated with the lack of knowledge of HIV/AIDS prevention methods, endorsement of HIV/AIDS transmission misconceptions, and never having been tested for HIV (p≤0.001). Women living in the rural areas, married, with lower education, and from low income households were less tolerant towards PLWHA.Conclusions: The data from Tajikistan underscore the persistence of HIV-related discriminatory attitudes among low socioeconomic status women. The study findings can be potentially used to target the disadvantaged groups and guide the design and implementation of programs that promote voluntary HIV-testing, raise awareness about HIV/AIDS prevention methods, and help dispel transmission misconceptions.

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