Role of western blot assay for the diagnosis of histoplasmosis in AIDS patients from a National Institute of Infectious Diseases in Rio de Janeiro, Brazil

Mycoses. 2019 Mar;62(3):261-267. doi: 10.1111/myc.12877. Epub 2019 Jan 22.

Abstract

Background: Histoplasmosis is a frequent fungal infection in HIV/AIDS patients, with high morbimortality rates when diagnosis and treatment are delayed. Antibody detection, which is faster than the gold standard culture test, hastens the laboratory investigation.

Objectives: To evaluate the role of WB for antibody detection in the diagnosis of histoplasmosis among HIV/AIDS patients.

Patients and methods: Fifty patients with proven or probable histoplasmosis were included. Clinical, epidemiological and laboratory data were described in the same population after a review of their medical records. WB was performed using deglycosylated histoplasmin.

Results: About 82% of patients were adult males and the mean age was 39.3 years. CD4+ T lymphocyte count less than 150 cells/mm3 was observed in 62% patients. Antibodies against Histoplasma capsulatum M antigen were detected in 62% of patients, and against both M and H antigens in 28% of individuals. Sera from 10% of patients were nonreactive. Histoplasmosis was the first opportunistic infection in 38% of the cases. Disseminated and pulmonary histoplasmosis occurred in 84% and 16% of patients, respectively. The overall mortality was 16%.

Conclusion: WB could be useful for the histoplasmosis diagnosis in HIV/AIDS patients because of its easefulness and good sensitivity in a population where antibody production is hampered.

Keywords: HIV/AIDS patients; antibody detection; histoplasmosis; immunodiagnosis; western blot.

Publication types

  • Evaluation Study

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Adult
  • Age Distribution
  • Antibodies, Fungal / blood*
  • Antigens, Fungal / immunology
  • Blotting, Western / methods*
  • Brazil / epidemiology
  • CD4 Lymphocyte Count
  • Diagnostic Tests, Routine / methods*
  • Female
  • Histoplasma / immunology*
  • Histoplasmosis / diagnosis*
  • Histoplasmosis / epidemiology
  • Histoplasmosis / mortality
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Sensitivity and Specificity
  • Sex Distribution
  • Survival Analysis

Substances

  • Antibodies, Fungal
  • Antigens, Fungal