Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Histoplasmosis at a Reference Center for Infectious Diseases in Southeast Brazil: Comparison between HIV Positive and HIV Negative Individuals

Ariane Gomes Paixão
,
Marcos Abreu Almeida
ORCID logo ,
Roberta Espírito Santo Correia
,
Beatriz Brittes Kamiensky
,
Rosely Maria Zancopé-Oliveira
,
Marcia dos Santos Lazera
,
Bodo Wanke
,
Cristiane da Cruz Lamas
* ORCID logo
Version 1 : Received: 25 April 2023 / Approved: 26 April 2023 / Online: 26 April 2023 (14:58:17 CEST)

A peer-reviewed article of this Preprint also exists.

Paixão, A.G.; Almeida, M.A.; Correia, R.E.S.; Kamiensky, B.B.; Zancopé-Oliveira, R.M.; Lazera, M.S.; Wanke, B.; Lamas, C.C. Histoplasmosis at a Reference Center for Infectious Diseases in Southeast Brazil: Comparison between HIV-Positive and HIV-Negative Individuals. Trop. Med. Infect. Dis. 2023, 8, 271. Paixão, A.G.; Almeida, M.A.; Correia, R.E.S.; Kamiensky, B.B.; Zancopé-Oliveira, R.M.; Lazera, M.S.; Wanke, B.; Lamas, C.C. Histoplasmosis at a Reference Center for Infectious Diseases in Southeast Brazil: Comparison between HIV-Positive and HIV-Negative Individuals. Trop. Med. Infect. Dis. 2023, 8, 271.

Abstract

Background: Histoplasmosis is a systemic mycosis, present globally. We aimed to describe cases of histoplasmosis (Hc) and to establish a risk profile associated to Hc in HIV-infected patients (HIV+). Methods: This was a retrospective study of patients with a clinical-. laboratorial diagnosis of Hc. Data was fed into REDCap and statistical analysis was done with R . Results: We included 99 records, 65 HIV+ and 34 HIV-. Average age was 39 years. Median time from onset to diagnosis was 8 weeks in HIV- and 22 weeks in HIV+. Disseminated histoplasmosis occurred in 79.4% HIV+, vs 36.4% HIV-. Median CD4 count was 70. Co-infection with tuberculosis was present in 20% of HIV+. Blood cultures were positive in 32.3% of HIV+ vs 11.8% of HIV- (p=0.025); bone marrow culture was positive in 36.9% vs 8.8%(p=0.003). Most HIV+ patients (71.4%) were hospitalized. On univariate analysis, anemia, leukopenia, intensive care, use of vasopressors and mechanical ventilation were associated with death in HIV+. Conclusions: Most of our patients with histoplasmosis were HIV+, presenting advanced AIDS. Diagnosis was late in HIV+ patients, and they frequently presented disseminated Hc, required hospitalization, and died. Early screening for Hc in HIV+ and drug induced immunosuppressed patients is crucial.

Keywords

Histoplasmosis; Brazil; Epidemiology; HIV positive; AIDS; Immunosuppression; Culture; Serology; Mortality

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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