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Open AccessReview

Histoplasmosis and Tuberculosis Co-Occurrence in People with Advanced HIV

1,2,*,† and 3,*,†
Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, 11011 Bogota, Colombia
Service de Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, 97306 Cayenne, French Guiana
Authors to whom correspondence should be addressed.
Contributed equally.
J. Fungi 2019, 5(3), 73;
Received: 14 July 2019 / Revised: 5 August 2019 / Accepted: 7 August 2019 / Published: 9 August 2019
(This article belongs to the Special Issue Histoplasma and Histoplasmosis)
PDF [630 KB, uploaded 9 August 2019]
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Distinguishing between histoplasmosis, tuberculosis (TB), and co-occurrence of disease is a frequent dilemma for clinical staff treating people with advanced Human Immunodeficiency Virus (HIV) infection. This problem is most frequently observed in clinical settings in countries where both diseases are endemic. It is also a challenge outside these endemic countries in HIV clinics that take care of patients coming from countries with endemic histoplasmosis and TB. The gold standard for diagnosis of both of these diseases is based on conventional laboratory tests (culture, histopathology and special stains). These tests have several limitations, such as lack of laboratory infrastructure for handling isolates (biosafety level 3), shortage of laboratory staff who have appropriate training and experience, variable analytical performance of tests and long turn-around time. Recently, novel rapid assays for the diagnosis of histoplasmosis and TB became available. However, this technology is not yet widely used. Mortality in immunocompromised patients, such as people with advanced HIV, is directly linked with the ability to rapidly diagnose opportunistic diseases. The aim of this review is to synthesize the main aspects of epidemiology, clinical characteristics, diagnosis and treatment of histoplasmosis/TB co-occurrence in people with advanced HIV. View Full-Text
Keywords: histoplasmosis; tuberculosis; HIV; AIDS; co-occurrence; epidemiology; diagnosis; treatment histoplasmosis; tuberculosis; HIV; AIDS; co-occurrence; epidemiology; diagnosis; treatment

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Caceres, D.H.; Valdes, A. Histoplasmosis and Tuberculosis Co-Occurrence in People with Advanced HIV. J. Fungi 2019, 5, 73.

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