Screening with urine Histoplasma antigen test in asymptomatic patients starting TNF-alpha inhibitor therapy: a cohort study

• Published in: Therapeutic advances in infectious disease 2024-01, Vol.11
• Main Authors: Cipolat, Murillo M., Rodrigues, Débora R. R., Silveira, Letícia G., Silveira, Inês G., Nothaft, Mahara S. V., Brenol, Claiton V., da Silva, Larissa R., Pasqualotto, Alessandro C., Falci, Diego R.
• Format: Article
• Language: English
• ISSN: 2049-9361; 2049-937X
• DOI: 10.1177/20499361231222134

Plain language summary Using a urine test for fungal infection to screen people without symptoms who are about to start taking immunobiologic medications This study looked at the prevalence of histoplasmosis, a fungal infection, in asymptomatic patients who were about to start treatment with TNF-α inhibitors, which are medications used for autoimmune diseases. The researchers tested urine samples for Histoplasma antigen before the patients started the treatment and followed them for 180 days after starting the medication to see if they developed any symptoms of histoplasmosis. The study included 54 patients in southern Brazil, and they found that 14.8% of the patients tested positive for the Histoplasma antigen before starting the treatment. However, none of the patients, including those who tested positive, developed histoplasmosis during the 6-month follow-up. The researchers concluded that histoplasmosis infection may be more common in these patients than previously thought, but it’s still not clear if asymptomatic patients with a positive antigen test will develop the infection when starting TNF-α inhibitor treatment. The study did not find any specific risk factors for developing histoplasmosis in this group of patients, and based on their findings, they did not recommend routine screening or preventive therapy for histoplasmosis before starting TNF-α inhibitor treatment.