The Fight against HIV-Associated Disseminated Histoplasmosis in the Americas: Unfolding the Different Stories of Four Centers

Mathieu Nacher; Terezinha Silva Leitao; Beatriz L Gómez; Pierre Couppié; Antoine Adenis; Lisandra Damasceno; Magalie Demar; Blanca Samayoa; Diego H Cáceres; Roger Pradinaud; Anastacio de Queiroz Sousa; Eduardo Arathoon; Angela Restrepo

doi:10.3390/jof5020051

The Fight against HIV-Associated Disseminated Histoplasmosis in the Americas: Unfolding the Different Stories of Four Centers

Título traducido de la contribución: La lucha contra la histoplasmosis diseminada asociada al VIH en las Américas: desvelando las diferentes historias de cuatro centros

Mathieu Nacher
, Terezinha Silva Leitao
, Beatriz L Gómez
, Pierre Couppié
, Antoine Adenis
, Lisandra Damasceno
, Magalie Demar
, Blanca Samayoa
, Diego H Cáceres
, Roger Pradinaud
, Anastacio de Queiroz Sousa
, Eduardo Arathoon
, Angela Restrepo

Producción científica: Contribución a revista › Artículo de Investigación › revisión exhaustiva

31 Citas (Scopus)

Resumen

La histoplasmosis diseminada es una de las principales infecciones oportunistas de los pacientes con VIH, que mata a miles de personas en América Latina cada año. Sin embargo, sigue siendo una enfermedad desatendida que a menudo se confunde con la tuberculosis, por falta de herramientas de diagnóstico simples, asequibles y rápidas. Existe una gran heterogeneidad en el nivel de concienciación sobre la histoplasmosis. El propósito de este informe fue describir cómo se produjo el "despertar" histórico ante la amenaza de la histoplasmosis en cuatro centros diferentes que han descrito activamente esta enfermedad: en Brasil, el hospital Sao José en Fortaleza; en Colombia, la Corporación para Investigaciones Biológicas en Medellín; en la Guayana Francesa, el Hospital de Cayena; y en Guatemala, la Asociación de Salud Integral en la ciudad de Guatemala. En Brasil y la Guayana Francesa, la búsqueda de leishmaniasis en la capa leucocítica o en los frotis de piel, respectivamente, condujo a la rápida comprensión de que los pacientes con VIH sufrían histoplasmosis diseminada. Con el tiempo y el progreso en el cultivo de hongos, la magnitud de este problema lo convirtió en una prioridad local. En Colombia y Guatemala, la historia es diferente, porque para estos centros de micología no fue una sorpresa encontrar histoplasmosis en pacientes con VIH. Además, las colaboraciones con los CDC para evaluar las pruebas de detección de antígenos dieron como resultado que los investigadores y los médicos desarrollaran la capacidad de detectar rápidamente a la mayoría de los pacientes y demostraran la altísima carga de la enfermedad en estos países. Si bien la falta de concienciación sigue siendo un problema importante, es instructivo revisar las formas en que los diferentes centros adquirieron conciencia sobre la histoplasmosis. Sin embargo, a medida que se disponga de nuevas herramientas de diagnóstico rápido, su implementación en toda América Latina debería aumentar rápidamente el nivel de concienciación para reducir la carga de muertes por histoplasmosis.

Título traducido de la contribución	La lucha contra la histoplasmosis diseminada asociada al VIH en las Américas: desvelando las diferentes historias de cuatro centros
Idioma original	Inglés estadounidense
Número de artículo	2
Publicación	Journal of Fungi
Volumen	5
N.º	2
DOI	https://doi.org/10.3390/jof5020051
Estado	Publicada - jun. 17 2019

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Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible

ODS 3: Salud y bienestar

Áreas temáticas de ASJC Scopus

Microbiología (médica)

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Nacher, M., Leitao, T. S., Gómez, B. L., Couppié, P., Adenis, A., Damasceno, L., Demar, M., Samayoa, B., Cáceres, D. H., Pradinaud, R., Sousa, A. D. Q., Arathoon, E., & Restrepo, A. (2019). The Fight against HIV-Associated Disseminated Histoplasmosis in the Americas: Unfolding the Different Stories of Four Centers. Journal of Fungi, 5(2), Artículo 2 . https://doi.org/10.3390/jof5020051

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title = "The Fight against HIV-Associated Disseminated Histoplasmosis in the Americas: Unfolding the Different Stories of Four Centers",

abstract = "Disseminated histoplasmosis is a major opportunistic infection of HIV-infected patients, killing thousands in Latin America each year. Yet, it remains a neglected disease that is often confused with tuberculosis, for lack of simple, affordable, and rapid diagnostic tools. There is great heterogeneity in the level of histoplasmosis awareness. The purpose of this report was to describe how the historical {"}awakening{"} to the threat of histoplasmosis came to be in four different centers that have actively described this disease: In Brazil, the Sao Jos{\'e} hospital in Fortaleza; in Colombia, the Corporaci{\'o}n para Investigaciones Biol{\'o}gicas in Medellin; in French Guiana, Cayenne Hospital; and in Guatemala, the Association de Salud Integral in Guatemala city. In Brazil and French Guiana, the search for leishmaniasis on the buffy coat or skin smears, respectively, led to the rapid realization that HIV patients were suffering from disseminated histoplasmosis. With time and progress in fungal culture, the magnitude of this problem turned it into a local priority. In Colombia and Guatemala, the story is different because for these mycology centers, it was no surprise to find histoplasmosis in HIV patients. In addition, collaborations with the CDC to evaluate antigen-detection tests resulted in researchers and clinicians developing the capacity to rapidly screen most patients and to demonstrate the very high burden of disease in these countries. While the lack of awareness is still a major problem, it is instructive to review the ways through which different centers became histoplasmosis-aware. Nevertheless, as new rapid diagnostic tools are becoming available, their implementation throughout Latin America should rapidly raise the level of awareness in order to reduce the burden of histoplasmosis deaths.",

author = "Mathieu Nacher and Leitao, \{Terezinha Silva\} and G{\'o}mez, \{Beatriz L\} and Pierre Couppi{\'e} and Antoine Adenis and Lisandra Damasceno and Magalie Demar and Blanca Samayoa and C{\'a}ceres, \{Diego H\} and Roger Pradinaud and Sousa, \{Anastacio de Queiroz\} and Eduardo Arathoon and Angela Restrepo",

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AU - Nacher, Mathieu

AU - Leitao, Terezinha Silva

AU - Gómez, Beatriz L

AU - Couppié, Pierre

AU - Adenis, Antoine

AU - Damasceno, Lisandra

AU - Demar, Magalie

AU - Samayoa, Blanca

AU - Cáceres, Diego H

AU - Pradinaud, Roger

AU - Sousa, Anastacio de Queiroz

AU - Arathoon, Eduardo

AU - Restrepo, Angela

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N2 - Disseminated histoplasmosis is a major opportunistic infection of HIV-infected patients, killing thousands in Latin America each year. Yet, it remains a neglected disease that is often confused with tuberculosis, for lack of simple, affordable, and rapid diagnostic tools. There is great heterogeneity in the level of histoplasmosis awareness. The purpose of this report was to describe how the historical "awakening" to the threat of histoplasmosis came to be in four different centers that have actively described this disease: In Brazil, the Sao José hospital in Fortaleza; in Colombia, the Corporación para Investigaciones Biológicas in Medellin; in French Guiana, Cayenne Hospital; and in Guatemala, the Association de Salud Integral in Guatemala city. In Brazil and French Guiana, the search for leishmaniasis on the buffy coat or skin smears, respectively, led to the rapid realization that HIV patients were suffering from disseminated histoplasmosis. With time and progress in fungal culture, the magnitude of this problem turned it into a local priority. In Colombia and Guatemala, the story is different because for these mycology centers, it was no surprise to find histoplasmosis in HIV patients. In addition, collaborations with the CDC to evaluate antigen-detection tests resulted in researchers and clinicians developing the capacity to rapidly screen most patients and to demonstrate the very high burden of disease in these countries. While the lack of awareness is still a major problem, it is instructive to review the ways through which different centers became histoplasmosis-aware. Nevertheless, as new rapid diagnostic tools are becoming available, their implementation throughout Latin America should rapidly raise the level of awareness in order to reduce the burden of histoplasmosis deaths.

AB - Disseminated histoplasmosis is a major opportunistic infection of HIV-infected patients, killing thousands in Latin America each year. Yet, it remains a neglected disease that is often confused with tuberculosis, for lack of simple, affordable, and rapid diagnostic tools. There is great heterogeneity in the level of histoplasmosis awareness. The purpose of this report was to describe how the historical "awakening" to the threat of histoplasmosis came to be in four different centers that have actively described this disease: In Brazil, the Sao José hospital in Fortaleza; in Colombia, the Corporación para Investigaciones Biológicas in Medellin; in French Guiana, Cayenne Hospital; and in Guatemala, the Association de Salud Integral in Guatemala city. In Brazil and French Guiana, the search for leishmaniasis on the buffy coat or skin smears, respectively, led to the rapid realization that HIV patients were suffering from disseminated histoplasmosis. With time and progress in fungal culture, the magnitude of this problem turned it into a local priority. In Colombia and Guatemala, the story is different because for these mycology centers, it was no surprise to find histoplasmosis in HIV patients. In addition, collaborations with the CDC to evaluate antigen-detection tests resulted in researchers and clinicians developing the capacity to rapidly screen most patients and to demonstrate the very high burden of disease in these countries. While the lack of awareness is still a major problem, it is instructive to review the ways through which different centers became histoplasmosis-aware. Nevertheless, as new rapid diagnostic tools are becoming available, their implementation throughout Latin America should rapidly raise the level of awareness in order to reduce the burden of histoplasmosis deaths.

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DO - 10.3390/jof5020051

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The Fight against HIV-Associated Disseminated Histoplasmosis in the Americas: Unfolding the Different Stories of Four Centers

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