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dc.contributor.authorMedina, Narda
dc.contributor.authorAlastruey-Izquierdo, Ana 
dc.contributor.authorBonilla, Oscar
dc.contributor.authorGamboa, Osmar
dc.contributor.authorMercado, Danicela
dc.contributor.authorPérez, Juan C
dc.contributor.authorSalazar, Luis Roberto
dc.contributor.authorArathoon, Eduardo
dc.contributor.authorDenning, David W
dc.contributor.authorRodriguez-Tudela, Juan Luis
dc.identifier.citationJ Fungi (Basel). 2021 Apr 1;7(4):268.es_ES
dc.description.abstractOpportunistic infections (OIs) and advanced HIV disease (AHD) contribute to HIV-related mortality. Here, we analyzed the situation of AHD and OIs in a cohort of newly diagnosed HIV patients from Guatemala. We included 2127 adult patients from 13 facilities across the country during 2017 to 2018. Patients were screened for tuberculosis (TB), nontuberculous mycobacteria (NTM), histoplasmosis, and cryptococcal disease, independently of their CD4 cell count. Of the 2127 enrolled patients, 1682 (79.1%) had a CD4 cell count available; of which 52% presented with AHD. Of the Mayan population, 65% had AHD. The overall OI incidence was 21%. Histoplasmosis was the most frequent OI (7.9%), followed by TB (7.1%); 94.4% of these infections occurred in patients with a CD4 < 350 cells/mm3. Mortality at 180 days was significantly higher in those with OIs than without OIs (29.7% vs. 5.9%, p < 0.0001). In one year, this program decreased the OI mortality by 7% and increased the OI treatment by 5.1%. Early OI diagnosis and appropriate therapy reduced OI mortality among newly diagnosed HIV patients in Guatemala. Screening for OIs should be considered in all newly diagnosed HIV patients who have a CD4 cell count < 350 cells/mm3 or those without a CD4 cell count available. To improve results, interventions such as early HIV detection and access to flucytosine and liposomal amphotericin B are required.es_ES
dc.description.sponsorshipThis work was supported by Global Action Fund for Fungal Infections and JYLAG, a charity Foundation based in Switzerland (E.A. received this funding under the proposal: “Minimising HIV deaths through rapid fungal diagnosis and better care in Guatemala”). Other contributions came from AIDS Health Foundation (AHF) Guatemala, Intrahealth International and Ministry of health in Guatemala (MSPAS).es_ES
dc.relation.isversionofPublisher's versiones_ES
dc.subjectlaboratory diagnosises_ES
dc.subjectopportunistic infectionses_ES
dc.titleA Rapid Screening Program for Histoplasmosis, Tuberculosis, and Cryptococcosis Reduces Mortality in HIV Patients from Guatemala.es_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderGlobal Action Fund for Fungal Infectionses_ES
dc.contributor.funderAIDS Health Foundation (AHF)es_ES
dc.contributor.funderIntrahealth Internationales_ES
dc.contributor.funderMinisterio de salud de Guatemalaes_ES
dc.identifier.journalJournal of fungi (Basel, Switzerland)es_ES
dc.repisalud.centroISCIII::Centro Nacional de Microbiologíaes_ES

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