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. 2022 Nov;28(11):2261-2269.
doi: 10.3201/eid2811.220542.

Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria

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

Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria

Rita O Oladele et al. Emerg Infect Dis. 2022 Nov.

Abstract

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.

Keywords: HIV/AIDS and other retroviruses; Nigeria; fungi; histoplasma; histoplasmosis; infections; respiratory infections; tuberculosis and other mycobacteria.

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Figures

Figure
Figure
Case-patients with tuberculosis-histoplasmosis co-infection in study of prevalence of histoplasmosis among advanced HIV disease patients in Nigeria. Ag, antigen; +, positive.
See this image and copyright information in PMC

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