Fungal biomarkers in HIV-associated disseminated histoplasmosis: a multicenter diagnostic accuracy study on the Guiana shield
Objectives: Diagnosis of HIV-associated histoplasmosis remains challenging. Our objective was to compare the performances of (1→3)-β-D-Glucan (BDG) and aspergillus galactomannan (GM) antigen for the diagnosis of HIV-associated histoplasmosis. Methods: We performed a diagnostic accuracy study using f...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-04-01
|
| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971224004351 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841545580825804800 |
|---|---|
| author | Aurore Moussiegt Sigrid Mac Donald Marie Elisabeth Bougnoux Marja Van Eer Stephen Vreden Tom Chiller Diego H. Caceres Beatriz L. Gomez Mathieu Nacher Olivier Lortholary Antoine Adenis |
| author_facet | Aurore Moussiegt Sigrid Mac Donald Marie Elisabeth Bougnoux Marja Van Eer Stephen Vreden Tom Chiller Diego H. Caceres Beatriz L. Gomez Mathieu Nacher Olivier Lortholary Antoine Adenis |
| author_sort | Aurore Moussiegt |
| collection | DOAJ |
| description | Objectives: Diagnosis of HIV-associated histoplasmosis remains challenging. Our objective was to compare the performances of (1→3)-β-D-Glucan (BDG) and aspergillus galactomannan (GM) antigen for the diagnosis of HIV-associated histoplasmosis. Methods: We performed a diagnostic accuracy study using frozen primary serum specimens issued from consecutive hospitalized people living with HIV (PLWH) and blindly tested for BDG and GM using FungitellⓇ and PlateliaTM Aspergillus, respectively. Results: We included 121 sera with 92 HIV-associated histoplasmosis cases and 29 negative controls. At thresholds of 150 pg/ml and 0.5 for BDG and GM, the sensitivity and specificity were 95% (85-100) vs 90% (77-100) and 52% (34-70) vs 83% (69-97), respectively. The receiver operating characteristics (ROC) curves showed area under the curves of 0.82 (0.68-0.91) vs 0.92 (0.80-0.98) for BDG and GM, respectively. Post-test probabilities showed best performances at lowest thresholds for a negative testing of BDG and GM and at the 0.7 threshold for a positive GM test. Conclusions: If BDG alone may rule out histoplasmosis when negative, GM alone, either positive or negative, showed the best performances for the diagnosis of histoplasmosis. Given the poorer performances of BDG and GM than Histoplasma antigen detection assays commercially available, they should be considered as an alternative in settings where Histoplasma antigen detection assays remain unavailable. However, this study essentially provides insights in the performances of fungal biomarkers in disseminated histoplasmosis and does not represent recommendations for best practices. |
| format | Article |
| id | doaj-art-51d1eb666ac045f083c760bac98eaaae |
| institution | Kabale University |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-51d1eb666ac045f083c760bac98eaaae2025-01-12T05:24:23ZengElsevierInternational Journal of Infectious Diseases1201-97122025-04-01153107360Fungal biomarkers in HIV-associated disseminated histoplasmosis: a multicenter diagnostic accuracy study on the Guiana shieldAurore Moussiegt0Sigrid Mac Donald1Marie Elisabeth Bougnoux2Marja Van Eer3Stephen Vreden4Tom Chiller5Diego H. Caceres6Beatriz L. Gomez7Mathieu Nacher8Olivier Lortholary9Antoine Adenis10Centre d'Investigation Clinique Antilles Guyane Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana; Corresponding author.Foundation for the Advancement of Scientific Research in Suriname SWOS, Paramaribo, Suriname; Department of Medical Microbiology, University of Amsterdam, Amsterdam UMC, Amsterdam, NetherlandsUnité de Parasitologie Mycologie, Hôpital Necker-Enfants Malades, APHP, Université Paris Cité, Paris, France; Institut Pasteur, Université Paris Cité, National Reference Center for Invasives Mycoses and Antifungals, Mycology Translational Research Group, Mycology Department, Paris, FranceFoundation for the Advancement of Scientific Research in Suriname SWOS, Paramaribo, SurinameFoundation for the Advancement of Scientific Research in Suriname SWOS, Paramaribo, SurinameMycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, USACenter of Expertise in Mycology Radboudumc/CWZ, Nijmegen, Netherlands; Studies in Translational Microbiology and Emerging Diseases (ITM/ MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; IMMY, 2701 Corporate Centre Dr, Norman, OK 73069, USAStudies in Translational Microbiology and Emerging Diseases (ITM/ MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, ColombiaCentre d'Investigation Clinique Antilles Guyane Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana; DFR Santé, Université de Guyane, Cayenne, French GuianaInstitut Pasteur, Université Paris Cité, National Reference Center for Invasives Mycoses and Antifungals, Mycology Translational Research Group, Mycology Department, Paris, France; Université Paris Cité, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, Necker Enfants Malades University Hospital, APHP, Paris, FranceCentre d'Investigation Clinique Antilles Guyane Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana; DFR Santé, Université de Guyane, Cayenne, French Guiana; CRB Amazonie, Centre Hospitalier de Cayenne, Cayenne, French GuianaObjectives: Diagnosis of HIV-associated histoplasmosis remains challenging. Our objective was to compare the performances of (1→3)-β-D-Glucan (BDG) and aspergillus galactomannan (GM) antigen for the diagnosis of HIV-associated histoplasmosis. Methods: We performed a diagnostic accuracy study using frozen primary serum specimens issued from consecutive hospitalized people living with HIV (PLWH) and blindly tested for BDG and GM using FungitellⓇ and PlateliaTM Aspergillus, respectively. Results: We included 121 sera with 92 HIV-associated histoplasmosis cases and 29 negative controls. At thresholds of 150 pg/ml and 0.5 for BDG and GM, the sensitivity and specificity were 95% (85-100) vs 90% (77-100) and 52% (34-70) vs 83% (69-97), respectively. The receiver operating characteristics (ROC) curves showed area under the curves of 0.82 (0.68-0.91) vs 0.92 (0.80-0.98) for BDG and GM, respectively. Post-test probabilities showed best performances at lowest thresholds for a negative testing of BDG and GM and at the 0.7 threshold for a positive GM test. Conclusions: If BDG alone may rule out histoplasmosis when negative, GM alone, either positive or negative, showed the best performances for the diagnosis of histoplasmosis. Given the poorer performances of BDG and GM than Histoplasma antigen detection assays commercially available, they should be considered as an alternative in settings where Histoplasma antigen detection assays remain unavailable. However, this study essentially provides insights in the performances of fungal biomarkers in disseminated histoplasmosis and does not represent recommendations for best practices.http://www.sciencedirect.com/science/article/pii/S1201971224004351HIVHistoplasmosisGlucanGalactomannanDiagnostic performances |
| spellingShingle | Aurore Moussiegt Sigrid Mac Donald Marie Elisabeth Bougnoux Marja Van Eer Stephen Vreden Tom Chiller Diego H. Caceres Beatriz L. Gomez Mathieu Nacher Olivier Lortholary Antoine Adenis Fungal biomarkers in HIV-associated disseminated histoplasmosis: a multicenter diagnostic accuracy study on the Guiana shield International Journal of Infectious Diseases HIV Histoplasmosis Glucan Galactomannan Diagnostic performances |
| title | Fungal biomarkers in HIV-associated disseminated histoplasmosis: a multicenter diagnostic accuracy study on the Guiana shield |
| title_full | Fungal biomarkers in HIV-associated disseminated histoplasmosis: a multicenter diagnostic accuracy study on the Guiana shield |
| title_fullStr | Fungal biomarkers in HIV-associated disseminated histoplasmosis: a multicenter diagnostic accuracy study on the Guiana shield |
| title_full_unstemmed | Fungal biomarkers in HIV-associated disseminated histoplasmosis: a multicenter diagnostic accuracy study on the Guiana shield |
| title_short | Fungal biomarkers in HIV-associated disseminated histoplasmosis: a multicenter diagnostic accuracy study on the Guiana shield |
| title_sort | fungal biomarkers in hiv associated disseminated histoplasmosis a multicenter diagnostic accuracy study on the guiana shield |
| topic | HIV Histoplasmosis Glucan Galactomannan Diagnostic performances |
| url | http://www.sciencedirect.com/science/article/pii/S1201971224004351 |
| work_keys_str_mv | AT auroremoussiegt fungalbiomarkersinhivassociateddisseminatedhistoplasmosisamulticenterdiagnosticaccuracystudyontheguianashield AT sigridmacdonald fungalbiomarkersinhivassociateddisseminatedhistoplasmosisamulticenterdiagnosticaccuracystudyontheguianashield AT marieelisabethbougnoux fungalbiomarkersinhivassociateddisseminatedhistoplasmosisamulticenterdiagnosticaccuracystudyontheguianashield AT marjavaneer fungalbiomarkersinhivassociateddisseminatedhistoplasmosisamulticenterdiagnosticaccuracystudyontheguianashield AT stephenvreden fungalbiomarkersinhivassociateddisseminatedhistoplasmosisamulticenterdiagnosticaccuracystudyontheguianashield AT tomchiller fungalbiomarkersinhivassociateddisseminatedhistoplasmosisamulticenterdiagnosticaccuracystudyontheguianashield AT diegohcaceres fungalbiomarkersinhivassociateddisseminatedhistoplasmosisamulticenterdiagnosticaccuracystudyontheguianashield AT beatrizlgomez fungalbiomarkersinhivassociateddisseminatedhistoplasmosisamulticenterdiagnosticaccuracystudyontheguianashield AT mathieunacher fungalbiomarkersinhivassociateddisseminatedhistoplasmosisamulticenterdiagnosticaccuracystudyontheguianashield AT olivierlortholary fungalbiomarkersinhivassociateddisseminatedhistoplasmosisamulticenterdiagnosticaccuracystudyontheguianashield AT antoineadenis fungalbiomarkersinhivassociateddisseminatedhistoplasmosisamulticenterdiagnosticaccuracystudyontheguianashield |