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The incidence of histoplasmosis and cryptococcal antigenemia among patients attending a large HIV clinic in Trinidad.
Edwards, Robert Jeffrey; Todd, Selena; Edwards, Jonathan; Samaroo-Francis, Wendy; Lyons, Nyla; Boyce, Gregory; Denning, David W.
Afiliación
  • Edwards RJ; Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad; Department of Paraclinical Sciences, University of the West Indies, St Augustine Trinidad. Electronic address: jeffreye2000@gmail.com.
  • Todd S; Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad.
  • Edwards J; Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad.
  • Samaroo-Francis W; Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad.
  • Lyons N; Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad.
  • Boyce G; Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad.
  • Denning DW; Manchester Fungal Infection Group, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK.
Diagn Microbiol Infect Dis ; 106(4): 115952, 2023 Aug.
Article en En | MEDLINE | ID: mdl-37267742
Our aim was to determine the incidence disseminated histoplasmosis and cryptococcal antigenemia among 280 patients with a CD4<350 cells/mm3 attending a large HIV clinic in Trinidad over the period November 2021-June 2022. Sera were screened for cryptococcal antigen (CrAg) using the Immy CrAg Immunoassay (EIA) and the Immy CrAg lateral flow assay (LFA). Urine was screened for Histoplasma antigen using the Immy EIA and the Optimum Imaging Diagnostics (OIDx) LFA. For the purposes of analysis, it was assumed, that all patients with positive urine Histoplasma antigen tests by both EIA and LFA and those with a single positive urine Histoplasma antigen test and clinical features of disseminated histoplasmosis were true positives. The incidence of probable disseminated histoplasmosis and cryptococcal antigenemia were 6.4% (18/280) and 2.5% (7/280) respectively. The sensitivity and specificity of the Immy Histoplasma EIA were 100% (95% CI, 81.5%-100%) and 98.5% (95% CI, 96.1% - 99.6%) respectively as compared to the OIDx Histoplasma LFA of 88.9% (95% CI, 65.3% - 98.6%) and 93.9% (95% CI, 90.3% - 96.5%) respectively, with substantial agreement between the 2 test kits (Kappa value = 0.763; 95% CI 0.685, 0.841). Testing for disseminated histoplasmosis in HIV patients is important in endemic areas.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Meningitis Criptocócica / Cryptococcus / Histoplasmosis Tipo de estudio: Diagnostic_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Caribe ingles / Trinidad y tobago Idioma: En Revista: Diagn Microbiol Infect Dis Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Meningitis Criptocócica / Cryptococcus / Histoplasmosis Tipo de estudio: Diagnostic_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Caribe ingles / Trinidad y tobago Idioma: En Revista: Diagn Microbiol Infect Dis Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos