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Communication

Summary of Guidelines for Managing Histoplasmosis among People Living with HIV

1
HIV, Hepatitis, Tuberculosis and Sexually Transmitted Infections Unit, Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, Washington, DC 20037, USA
2
Mycotic Diseases Branch, United States Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
3
Center of Expertise in Mycology Radboudumc/CWZ, 9101 Nijmegen, The Netherlands
4
HIV Department, World Health Organization, 1202 Geneva, Switzerland
5
School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia
6
Universidade Federal de Ciências da Saúde de Porto Alegre and Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90050-170, Brazil
7
Cochrane Infectious Diseases Group, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
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Centre d’Investigation Clinique Antilles Guyane, CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, France
9
Department of Medicine, Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, MD 21201, USA
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Full list of the authors and collaborators is provided in the Acknowledgements part.
Academic Editor: Spinello Antinori
J. Fungi 2021, 7(2), 134; https://doi.org/10.3390/jof7020134
Received: 5 January 2021 / Revised: 4 February 2021 / Accepted: 8 February 2021 / Published: 12 February 2021
(This article belongs to the Special Issue Histoplasma and Histoplasmosis 2020)
Histoplasmosis is a frequent fungal opportunistic infection in people living with HIV (PLHIV), associated every year to a total of 5% to 15% of AIDS-related deaths among this population. In 2020, the first global guidelines for diagnosing and managing disseminated histoplasmosis among PLHIV was published. This document recommends (1) detection of circulating Histoplasma antigens as the recommended laboratory assay to diagnose histoplasmosis among PLHIV; (2) the use of liposomal amphotericin for induction therapy in severe or moderately severe disease, followed by a maintenance therapy with itraconazole for 12 months; a shorter maintenance therapy could be considered if the patient is clinically stable and if immune status has improved; (3) antiretroviral therapy initiation as soon as possible among patients with histoplasmosis without involvement of central nervous system; and (4) that for the treatment of co-infection with histoplasmosis and tuberculosis (TB), treatment of TB should be initiated according to the World Health Organization treatment guidelines. Appropriate health education of providers, supportive supervision, and policy guidance for the care of PLHIV are required. View Full-Text
Keywords: advanced HIV disease; diagnosis; histoplasmosis; Histoplasma; guidelines; World Health Organization (WHO); Pan American Health Organization (PAHO) advanced HIV disease; diagnosis; histoplasmosis; Histoplasma; guidelines; World Health Organization (WHO); Pan American Health Organization (PAHO)
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MDPI and ACS Style

Perez, F.; Caceres, D.H.; Ford, N.; Ravasi, G.; Gomez, B.L.; Pasqualotto, A.C.; Hine, P.; Adenis, A.A.; Nacher, M.; Chiller, T.; Baddley, J.; for the Guideline Development Group for diagnosing and managing disseminated histoplasmosis among people living with HIV. Summary of Guidelines for Managing Histoplasmosis among People Living with HIV. J. Fungi 2021, 7, 134. https://doi.org/10.3390/jof7020134

AMA Style

Perez F, Caceres DH, Ford N, Ravasi G, Gomez BL, Pasqualotto AC, Hine P, Adenis AA, Nacher M, Chiller T, Baddley J, for the Guideline Development Group for diagnosing and managing disseminated histoplasmosis among people living with HIV. Summary of Guidelines for Managing Histoplasmosis among People Living with HIV. Journal of Fungi. 2021; 7(2):134. https://doi.org/10.3390/jof7020134

Chicago/Turabian Style

Perez, Freddy, Diego H. Caceres, Nathan Ford, Giovanni Ravasi, Beatriz L. Gomez, Alessandro C. Pasqualotto, Paul Hine, Antoine A. Adenis, Mathieu Nacher, Tom Chiller, John Baddley, and for the Guideline Development Group for diagnosing and managing disseminated histoplasmosis among people living with HIV. 2021. "Summary of Guidelines for Managing Histoplasmosis among People Living with HIV" Journal of Fungi 7, no. 2: 134. https://doi.org/10.3390/jof7020134

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