Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria
Rita Oladele, Iriagbonse I. Osaigbovo, Sulaimon Akanmu, Olukemi Adekanmbi, Bassey E. Ekeng, Yahaya Mohammed, Mary A. Alex-Wele, Mark Ojogba Okolo, Stephen T. Ayanbeku, Uchechukwu S. Unigwe, Iorhen E. Akase, Alali Dan-Jumbo, Dennis Isralski, David W. Denning, Alessandro C. Pasqualotto, Tom Chiller
Abstract
H istoplasmosis, an invasive fungal infection en- demic in the Americas, Africa, and Asia, with a few cases reported among immigrants to Europe, was classified as an AIDS-defining disease in 1987 (1,2). Incidence of disseminated histoplasmosis is 5%-25% in persons with advanced HIV disease (AHD; World Health Organization [WHO]-preferred term for AIDS), and according to recent data from South America, mortality rates are similar to those for tuberculosis among this patient group (3,4). In Latin America, high prevalence rates have been reported for disseminated histoplasmosis in AHD populations in Brazil (22%; 123/570) and Mexico (30%; 85/288) (5,6). Histoplasmosis is the most common AIDS-defining infection in Guatemala, more common than tuberculosis (7). In a recent study from Cameroon, 26% (36/138) of HIV patients had Histoplasma antigen in their urine regardless of CD4 count; a 2015 report indicated a 13% (7/56) prevalence in the AHD population