Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria
oleh: Rita O. Oladele, Iriagbonse I. Osaigbovo, Alani S. Akanmu, Olukemi A. Adekanmbi, Bassey E. Ekeng, Yahaya Mohammed, Mary A. Alex-Wele, Mark O. Okolo, Stephen T. Ayanbeku, Uchechukwu S. Unigwe, Iorhen E. Akase, Alali Dan-Jumbo, Dennis Isralski, David W. Denning, Alessandro C. Pasqualotto, Tom Chiller
| Format: | Article |
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| Diterbitkan: | Centers for Disease Control and Prevention 2022-11-01 |
Deskripsi
We sought to determine the prevalence of probable disseminated histoplasmosis among advanced HIV disease (AHD) patients in Nigeria. We conducted a cross-sectional study in 10 sites across 5 of 6 geopolitical zones in Nigeria. We identified patients with urinary samples containing CD4 cell counts <200 cells/mm3 or World Health Organization stage 3 or 4 disease who also had >2 clinical features of disseminated histoplasmosis, and we tested them for Histoplasma antigen using a Histoplasma enzyme immune assay. Of 988 participants we recruited, 76 (7.7%) were antigen-positive. The 76 Histoplasma antigen–positive participants had significantly lower (p = 0.03) CD4 counts; 9 (11.8%) were also co-infected with tuberculosis. Most antigen-positive participants (50/76; 65.8%; p = 0.015) had previously received antiretroviral treatment; 26/76 (34.2%) had not. Because histoplasmosis is often a hidden disease among AHD patients in Nigeria, Histoplasma antigen testing should be required in the AHD package of care.