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A complementary tool for management of disseminated Histoplasma capsulatum var. capsulatum infections in AIDS patients. ; A complementary tool for management of disseminated Histoplasma capsulatum var. capsulatum infections in AIDS patients. : A complementary tool for histoplasmosis management
Auteur(s) : Iriart, Xavier Blanchet, Denis Menard, Sandie Lavergne, Rose-Anne Chauvin, Pamela Adenis, Antoine Cassaing, Sophie Fillaux, Judith
Auteurs secondaires : Service de Parasitologie et Mycologie ; CHU Toulouse [Toulouse] - Hôpital Purpan - Institut Fédératif de Biologie (IFB) Centre de physiopathologie de Toulouse Purpan (CPTP) ; Université Paul Sabatier - Toulouse 3 (UPS) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Centre National de la Recherche Scientifique (CNRS) Laboratoire Hospitalier et Universitaire Parasitologie Mycologie ; Centre Hospitalier de Cayenne Centre d'investigation clinique Antilles-Guyane ; Institut National de la Santé et de la Recherche Médicale (INSERM) - CH Cayenne Epidémiologie des parasitoses et mycoses tropicales ; Université des Antilles et de la Guyane (UAG) - Institut National de la Santé et de la Recherche Médicale (INSERM) Service de Dermatologie et Vénérologie ; Centre Hospitalier de Cayenne Andrée Rosemon

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
: In South America, disseminated histoplasmosis due to Histoplasma capsulatum var. capsulatum (H. capsulatum), is a severe and frequent opportunistic infection in AIDS patients. In areas outside the USA where specific-Histoplasma antigen detection is not available, the diagnosis is difficult. With the galactomannan antigen (GM) detection, a test commonly used for invasive aspergillosis diagnosis, there is a cross-reactivity with H. capsulatum that can be helpful for the diagnosis of histoplasmosis. The aim of this study was to evaluate the GM detection for the diagnosis of disseminated histoplasmosis in AIDS patients. The performance of the GM detection was evaluated with serum collected in French Guiana where H. capsulatum is highly endemic. Sera from AIDS patients with disseminated histoplasmosis occurring from 2002 to 2009 and from control HIV-positive patients without histoplasmosis were tested with the GM detection and Histoplasma-specific antibody detection (IEP). In 39 AIDS patients with proven disseminated histoplasmosis, the sensitivity of the Histoplasma IEP was only 35.9% and was linked to the TCD4+ lymphocyte level. For the GM detection, the sensitivity (Se) was 76.9% and specificity (Sp) was 100% with the recommended threshold for aspergillosis diagnosis (0.5). The test was more efficient with a threshold of 0.4 (Se: 0.82 [95% CI: 0.66-0.92], Sp: 1.00 [95% CI: 0.86-1.00], LR+: >10, LR-: 0.18). This study confirms that the GM detection can be a surrogate marker for the diagnosis of disseminated histoplasmosis in AIDS patients in endemic areas where Histoplasma EIA is not available.
ISSN: 1438-4221

inserm-01065096
http://www.hal.inserm.fr/inserm-01065096
http://www.hal.inserm.fr/inserm-01065096/document
http://www.hal.inserm.fr/inserm-01065096/file/2014_Iriart_-_Complementary_tool_for_managementsur histo_infections_in_AID.pdf
DOI : 10.1016/j.ijmm.2014.07.016

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