Antoine A Adenis1, Audrey Valdes2, Claire Cropet2, Orion Z McCotter3, Gordana Derado4, Pierre Couppie5, Tom Chiller3, Mathieu Nacher6. 1. Centre d'Investigation Clinique 1424 Antilles-Guyane, Inserm, Centre Hospitalier de Cayenne, Cayenne, France; Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, Cayenne, France. Electronic address: antoine.adenis@ch-cayenne.fr. 2. Centre d'Investigation Clinique 1424 Antilles-Guyane, Inserm, Centre Hospitalier de Cayenne, Cayenne, France. 3. Mycotic Diseases Branch, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. 4. Biostatistics and Information Management Office, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. 5. Service de Dermatologie Vénérologie, Centre Hospitalier de Cayenne, Cayenne, France; Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, Cayenne, France. 6. Centre d'Investigation Clinique 1424 Antilles-Guyane, Inserm, Centre Hospitalier de Cayenne, Cayenne, France; Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, Cayenne, France.
Abstract
BACKGROUND: Fungal infections remain a major contributor to the opportunistic infections that affect people living with HIV. Among them, histoplasmosis is considered neglected, often being misdiagnosed as tuberculosis, and is responsible for numerous deaths in Latin America. The objective of this study was to estimate the burden of HIV-associated histoplasmosis compared with tuberculosis in Latin American countries. METHODS: For this modelling study, we estimated prevalence of previous exposure to Histoplasma capsulatum, HIV-associated histoplasmosis annual incidence, and number of deaths in 2012 in Latin American countries based on historical histoplasmin skin test studies in the general population, with an antigen dilution level of more than 1/10. Studies were identified in a literature search. Data on HIV-associated tuberculosis were extracted from the WHO notifications and outcomes tables and data on people living with HIV were extracted from the UNAIDS report for the year 2012. We systematically propagated uncertainty throughout all the steps of the estimation process. FINDINGS: Among 1310 articles identified as of June 1, 2015, 24 articles were included in the study, representing 129 histoplasmin skin test studies led in the general population of Latin American countries. For the year 2012, we estimated a range of 6710 (95% CI 5680-7867) to 15 657 (13 254-18 357) cases of symptomatic HIV-associated histoplasmosis in Latin America. Hotspot areas for histoplasmosis prevalence (>30%) and incidence (>1·5 cases per 100 people living with HIV) were Central America, the northernmost part of South America, and Argentina. According to realistic scenarios, we estimated a range of 671 (95% CI 568-787) to 9394 (7952-11 014) deaths related to histoplasmosis, compared with 5062 (3777-6405) deaths related to tuberculosis reported in Latin America. INTERPRETATION: Our estimates of histoplasmosis incidence and deaths are high and consistent with published data. For the first time, the burden of histoplasmosis is estimated to be equivalent in incidence and even higher in deaths when compared with tuberculosis among people living with HIV in Latin America. FUNDING: None.
BACKGROUND:Fungal infections remain a major contributor to the opportunistic infections that affect people living with HIV. Among them, histoplasmosis is considered neglected, often being misdiagnosed as tuberculosis, and is responsible for numerous deaths in Latin America. The objective of this study was to estimate the burden of HIV-associated histoplasmosis compared with tuberculosis in Latin American countries. METHODS: For this modelling study, we estimated prevalence of previous exposure to Histoplasma capsulatum, HIV-associated histoplasmosis annual incidence, and number of deaths in 2012 in Latin American countries based on historical histoplasmin skin test studies in the general population, with an antigen dilution level of more than 1/10. Studies were identified in a literature search. Data on HIV-associated tuberculosis were extracted from the WHO notifications and outcomes tables and data on people living with HIV were extracted from the UNAIDS report for the year 2012. We systematically propagated uncertainty throughout all the steps of the estimation process. FINDINGS: Among 1310 articles identified as of June 1, 2015, 24 articles were included in the study, representing 129 histoplasmin skin test studies led in the general population of Latin American countries. For the year 2012, we estimated a range of 6710 (95% CI 5680-7867) to 15 657 (13 254-18 357) cases of symptomatic HIV-associated histoplasmosis in Latin America. Hotspot areas for histoplasmosis prevalence (>30%) and incidence (>1·5 cases per 100 people living with HIV) were Central America, the northernmost part of South America, and Argentina. According to realistic scenarios, we estimated a range of 671 (95% CI 568-787) to 9394 (7952-11 014) deaths related to histoplasmosis, compared with 5062 (3777-6405) deaths related to tuberculosis reported in Latin America. INTERPRETATION: Our estimates of histoplasmosis incidence and deaths are high and consistent with published data. For the first time, the burden of histoplasmosis is estimated to be equivalent in incidence and even higher in deaths when compared with tuberculosis among people living with HIV in Latin America. FUNDING: None.
Authors: Bright K Ocansey; Benjamin Otoo; Isabella Asamoah; Vincent Ganu; Kofi P Berko; Oluwakemi Oladele; Emmanuella A Amankwa; Bismark Opoku-Asare; Martin Agyei; Lawrence George; Fleischer C N Kotey; Chris Kosmidis; Peter Puplampu; Japheth A Opintan; David W Denning Journal: Open Forum Infect Dis Date: 2022-06-03 Impact factor: 4.423
Authors: Leticia Bernal-Martínez; Laura Herrera; Clara Valero; Paula de la Cruz; Larisa Ghimpu; Ana C Mesa-Arango; Gabriela Santoni; Lidia Goterris; Rosario Millán; María José Buitrago Journal: J Fungi (Basel) Date: 2021-04-27
Authors: Freddy Perez; Diego H Caceres; Nathan Ford; Giovanni Ravasi; Beatriz L Gomez; Alessandro C Pasqualotto; Paul Hine; Antoine A Adenis; Mathieu Nacher; Tom Chiller; John Baddley Journal: J Fungi (Basel) Date: 2021-02-12