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Volume 30, Number 8—August 2024
Synopsis

Systematic Review of Prevalence of Histoplasma Antigenuria in Persons with HIV in Latin America and Africa

Preethiya Sekar, Gila Hale, Jane Gakuru, David B. Meya, David R. Boulware, Jayne Ellis, Elizabeth Nalintya, Nathan C. Bahr, and Radha RajasinghamComments to Author 
Author affiliations: University of Minnesota, Minneapolis, Minnesota, USA (P. Sekar, D.R. Boulware, N.C. Bahr, R. Rajasingham); Makerere University Infectious Diseases Institute, Kampala, Uganda (G. Hale, J. Gakuru, D.B. Meya, E. Nalintya); London School of Hygiene and Tropical Medicine, London, UK (J. Ellis); University of Kansas, Kansas City, Kansas, USA (N.C. Bahr)

Main Article

Table

Characteristics of Histoplasma urine antigen prevalence studies included in systematic review of prevalence of Histoplasma antigenuria in persons with HIV in Latin America and Africa*

Reference Country Study design Study population† Clinical status Setting Test type‡ No. participants No. samples tested HUA positivity, %
(14)
 Tanzania
 Cross-sectional
 All HIV and non-HIV
 Symptomatic
 Inpatient
 MV EIA
 628
 628
 1.1
(15)
 Uganda
 Cohort
 Advanced HIV
 Asymptomatic
 Outpatient
 IMMY GM EIA
 388
 388
 1.0
(16)
 Uganda
 Cohort
 Advanced HIV/meningitis
 Symptomatic
 Inpatient
 MV EIA
 257
 257
 0.0
(17)
 South Africa
 Cross-sectional
 Advanced HIV
 Symptomatic
 Outpatient
 IMMY Alpha EIA
 34
 17
 23.5
(18)
 South Africa
 Cross-sectional
 Advanced HIV
 Asymptomatic
 Inpatient
 IMMY GM EIA
 189
 189
 5.8
(19)
 Cameroon
 Cross-sectional
 All HIV
 Asymptomatic
 Outpatient
 OIDx EIA
 138
 138
 26.1
(20)
 Ghana
 Cross-sectional
 All HIV
 Asymptomatic
 Outpatient
 IMMY GM EIA + OIDx LFA
 150
 107
 5.6
(21)
 Nigeria
 Cross-sectional
 Advanced HIV
 Symptomatic
 Outpatient
 IMMY GM EIA
 213
 41
 7.3
(22)
 Nigeria
 Cross-sectional
 Advanced HIV
 Symptomatic
 Inpatient
 IMMY GM EIA
 988
 988
 7.7
(23)
 Mexico
 Cohort
 Advanced HIV
 Symptomatic
 Inpatient
 IMMY Alpha EIA
 288
 288
 21.5
(24)
 Brazil
 Cohort
 Advanced HIV
 Asymptomatic
 Inpatient
 IMMY Alpha EIA
 106
 106
 3.8
(25)
 Colombia
 Cross- sectional
 Advanced HIV
 Symptomatic
 Inpatient
 IMMY Alpha EIA
 172
 172
 29.1
(26)
 Colombia
 Cross-sectional
 Advanced HIV
 Asymptomatic
 Outpatient
 CDC ELISA
 768
 154
 20.1
(27)
 Panama, Honduras, Nicaragua
 Cross-sectional
 All HIV
 Symptomatic
 Inpatient
 IMMY GM EIA
 4453
 1343
 20.0
(28) Trinidad Cross-sectional HIV Asymptomatic Outpatient IMMY GM EIA + OIDx LFA 280 280 6.4

*EIA, enzyme immunoessay; GM, galactomannan; HUA, histoplasma urine antigen; LFA, lateral flow assay. †All HIV refers to participants with HIV who were not stratified by CD4 or limited to CD4 counts <200, such as persons in advanced HIV cohorts. ‡Test manufacturers and types: MV, MiraVista Diagnostics EIA (https://miravistalabs.com); IMMY Alpha and GM EIAs (https://www.immy.com); OIDx, Optimum Imaging Diagnostics LFA (https://optimumimaging.com).

Main Article

References
  1. Adenis  AA. AIDS-related histoplasmosis in Latin America [abstract]. Med Mycol. 2018;56(Suppl 2):S7.
  2. Samayoa  B, Roy  M, Cleveland  AA, Medina  N, Lau-Bonilla  D, Scheel  CM, et al. High mortality and coinfection in a prospective cohort of human immunodeficiency virus/acquired immune deficiency syndrome patients with histoplasmosis in Guatemala. Am J Trop Med Hyg. 2017;97:42–8. DOIPubMedGoogle Scholar
  3. Adenis  AA, Valdes  A, Cropet  C, McCotter  OZ, Derado  G, Couppie  P, et al. Burden of HIV-associated histoplasmosis compared with tuberculosis in Latin America: a modelling study. Lancet Infect Dis. 2018;18:1150–9. DOIPubMedGoogle Scholar
  4. Ashraf  N, Kubat  RC, Poplin  V, Adenis  AA, Denning  DW, Wright  L, et al. Re-drawing the maps for endemic mycoses. Mycopathologia. 2020;185:843–65. DOIPubMedGoogle Scholar
  5. Adenis  A, Nacher  M, Hanf  M, Basurko  C, Dufour  J, Huber  F, et al. Tuberculosis and histoplasmosis among human immunodeficiency virus-infected patients: a comparative study. Am J Trop Med Hyg. 2014;90:216–23. DOIPubMedGoogle Scholar
  6. Villareal  K, Price  A, Pasqualotto  AC, Bahr  NC. The current and future states of diagnostic tests for histoplasmosis with a focus on people with HIV and disseminated histoplasmosis. J Fungi (Basel). 2023;9:793793. DOIPubMedGoogle Scholar
  7. Martínez-Gamboa  A, Niembro-Ortega  MD, Torres-González  P, Santiago-Cruz  J, Velázquez-Zavala  NG, Rangel-Cordero  A, et al. 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. PLoS Negl Trop Dis. 2021;15:e0009215. DOIPubMedGoogle Scholar
  8. Cáceres  DH, Gómez  BL, Tobón  ÁM, Chiller  TM, Lindsley  MD. Evaluation of OIDx Histoplasma urinary antigen EIA. Mycopathologia. 2022;187:129–31. DOIPubMedGoogle Scholar
  9. Torres-González  P, Niembro-Ortega  MD, Martínez-Gamboa  A, Ahumada-Topete  VH, Andrade-Villanueva  J, Araujo-Meléndez  J, et al. Diagnostic accuracy cohort study and clinical value of the Histoplasma urine antigen (ALPHA Histoplasma EIA) for disseminated histoplasmosis among HIV infected patients: A multicenter study. PLoS Negl Trop Dis. 2018;12:e0006872. DOIPubMedGoogle Scholar
  10. Theel  ES, Jespersen  DJ, Harring  J, Mandrekar  J, Binnicker  MJ. Evaluation of an enzyme immunoassay for detection of Histoplasma capsulatum antigen from urine specimens. J Clin Microbiol. 2013;51:3555–9. DOIPubMedGoogle Scholar
  11. Goldet  G, Howick  J. Understanding GRADE: an introduction. J Evid Based Med. 2013;6:50–4. DOIPubMedGoogle Scholar
  12. Caceres  DH, Knuth  M, Derado  G, Lindsley  MD. Diagnosis of progressive disseminated histoplasmosis in advanced HIV: a meta-analysis of assay analytical performance. J Fungi (Basel). 2019;5:76. DOIPubMedGoogle Scholar
  13. Abdallah  W, Myint  T, LaRue  R, Minderman  M, Gunn  S, Wheat  LJ, et al. Diagnosis of histoplasmosis using the MVista Histoplasma galactomannan antigen qualitative lateral flow-based immunoassay: a multicenter study. Open Forum Infect Dis. 2021;8:ofab454.
  14. Lofgren  SM, Kirsch  EJ, Maro  VP, Morrissey  AB, Msuya  LJ, Kinabo  GD, et al. Histoplasmosis among hospitalized febrile patients in northern Tanzania. Trans R Soc Trop Med Hyg. 2012;106:504–7. DOIPubMedGoogle Scholar
  15. Sekar  P, Nalintya  E, Kwizera  R, Mukashyaka  C, Niyonzima  G, Namakula  LO, et al. Prevalence of Histoplasma antigenuria among outpatient cohort with advanced HIV in Kampala, Uganda. J Fungi (Basel). 2023;9:757. DOIPubMedGoogle Scholar
  16. Bahr  NC, Sarosi  GA, Meya  DB, Bohjanen  PR, Richer  SM, Swartzentruber  S, et al. Seroprevalence of histoplasmosis in Kampala, Uganda. Med Mycol. 2016;54:295–300. DOIPubMedGoogle Scholar
  17. Schwartz  IS, Kenyon  C, Lehloenya  R, Claasens  S, Spengane  Z, Prozesky  H, et al. AIDS-related endemic mycoses in western Cape, South Africa, and clinical mimics: a cross-sectional study of adults with advanced HIV and recent-onset, widespread skin lesions. Open Forum Infect Dis. 2017;4:ofx186. DOIPubMedGoogle Scholar
  18. van Schalkwyk  E, Mhlanga  M, Maphanga  TG, Mpembe  RS, Shillubane  A, Iyaloo  S, et al. Screening for invasive fungal disease using non-culture-based assays among inpatients with advanced HIV disease at a large academic hospital in South Africa. Mycoses. 2020;63:478–87. DOIPubMedGoogle Scholar
  19. Kuate  MPN, Nyasa  R, Mandengue  C, Tendongfor  N, Bongomin  F, Denning  DW. Screening for acute disseminated histoplasmosis in HIV disease using urinary antigen detection enzyme immunoassay: A pilot study in Cameroon. J Microbiol Methods. 2021;185:106226. DOIPubMedGoogle Scholar
  20. Ocansey  BK, Otoo  B, Asamoah  I, Ganu  V, Berko  KP, Oladele  O, et al. Cryptococcal and Histoplasma antigen screening among people with human immunodeficiency virus in Ghana and comparative analysis of OIDx Histoplasma lateral flow assay and IMMY Histoplasma enzyme immunoassay. Open Forum Infect Dis. 2022;9:ofac277.
  21. Ekeng  BE, Oladele  RO, Emanghe  UE, Ochang  EA, Mirabeau  TY. Prevalence of histoplasmosis and molecular characterization of Histoplasma species in patients with presumptive pulmonary tuberculosis in Calabar, Nigeria. Open Forum Infect Dis. 2022;9:ofac368.
  22. Oladele  RO, Osaigbovo  II, Akanmu  AS, Adekanmbi  OA, Ekeng  BE, Mohammed  Y, et al. Prevalence of histoplasmosis among persons with advanced HIV disease, Nigeria. Emerg Infect Dis. 2022;28:2261–9. DOIPubMedGoogle Scholar
  23. Torres-González  P, Niembro-Ortega  MD, Martínez-Gamboa  A, Ahumada-Topete  VH, Andrade-Villanueva  J, Araujo-Meléndez  J, et al. Diagnostic accuracy cohort study and clinical value of the Histoplasma urine antigen (ALPHA Histoplasma EIA) for disseminated histoplasmosis among HIV infected patients: A multicenter study. PLoS Negl Trop Dis. 2018;12:e0006872. DOIPubMedGoogle Scholar
  24. Vidal  JE, Werlang  PC, Muniz  BM, Rego  CM, Barbalho  RE, Baptista  AM, et al. Combining urine antigen and blood polymerase chain reaction for the diagnosis of disseminated histoplasmosis in hospitalized patients with advanced HIV disease. Med Mycol. 2021;59:916–22. DOIPubMedGoogle Scholar
  25. Hoyos Pulgarin  JA, Alzate Piedrahita  JA, Moreno Gómez  GA, Sierra Palacio  JF, Ordoñez  KM, Arias Ramos  D. Closing gaps in histoplasmosis: clinical characteristics and factors associated with probable/histoplasmosis in HIV/AIDS hospitalized patients, a retrospective cross-sectional study in two tertiary centers in Pereira, Colombia. AIDS Res Ther. 2021;18:51. DOIPubMedGoogle Scholar
  26. Caceres  DH, Zuluaga  A, Arango-Bustamante  K, de Bedout  C, Tobón  ÁM, Restrepo  Á, et al. Implementation of a training course increased the diagnosis of histoplasmosis in Colombia. Am J Trop Med Hyg. 2015;93:662–7. DOIPubMedGoogle Scholar
  27. Caceres  DH, Arauz  AB, Flores  C, Santiago  E, Montoya  S, Saenz  C, et al. Implementation of rapid diagnostics assays for detection of histoplasmosis and cryptococcosis in central american people living with HIV. Mycoses. 2021;64:1396–401. DOIPubMedGoogle Scholar
  28. Edwards  RJ, Todd  S, Edwards  J, Samaroo-Francis  W, Lyons  N, Boyce  G, et al. The incidence of histoplasmosis and cryptococcal antigenemia among patients attending a large HIV clinic in Trinidad. Diagn Microbiol Infect Dis. 2023;106:115952. DOIPubMedGoogle Scholar

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Page created: May 22, 2024
Page updated: July 20, 2024
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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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