2026-07-21T21:47:56Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/128922024-09-27T23:15:28Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19609
Repisalud
author
Medina, Narda
author
Alastruey-Izquierdo, Ana
author
Bonilla, Oscar
author
Gamboa, Osmar
author
Mercado, Danicela
author
Pérez, Juan C
author
Salazar, Luis Roberto
author
Arathoon, Eduardo
author
Denning, David W
author
Rodriguez-Tudela, Juan Luis
funder
Global Action Fund for Fungal Infections
funder
Fondation JYLAG
funder
AIDS Healthcare Foundation
funder
IntraHealth International
funder
Ministerio de Salud (Guatemala)
2021-05-06T11:39:34Z
2021-05-06T11:39:34Z
2021-04-01
J Fungi (Basel). 2021 Apr 1;7(4):268.
10.3390/jof7040268
2309-608X
Journal of fungi (Basel, Switzerland)
33916153
http://hdl.handle.net/20.500.12105/12892
Opportunistic 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.
eng
Cryptococcosis
Histoplasmosis
Laboratory diagnosis
Opportunistic infections
Tuberculosis
A Rapid Screening Program for Histoplasmosis, Tuberculosis, and Cryptococcosis Reduces Mortality in HIV Patients from Guatemala.
journal article
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ARapidScreeningProgram_2021.pdf
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https://repisalud.isciii.es/bitstreams/c66a2b69-9f04-462e-9910-639ebe8abfbd/download
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text/plain
ARapidScreeningProgram_2021.pdf.txt