Summary of Guidelines for Managing Histoplasmosis among People Living with HIV

Histoplasmosis is a frequent fungal opportunistic infection in people living with HIV (PLHIV), associated every year to a total of 5% to 15% of AIDS-related deaths among this population. In 2020, the first global guidelines for diagnosing and managing disseminated histoplasmosis among PLHIV was publ...

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Bibliographic Details
Published in:Journal of fungi (Basel) 2021-02, Vol.7 (2), p.134
Main Authors: Perez, Freddy, Caceres, Diego H, Ford, Nathan, Ravasi, Giovanni, Gomez, Beatriz L, Pasqualotto, Alessandro C, Hine, Paul, Adenis, Antoine A, Nacher, Mathieu, Chiller, Tom, Baddley, John, For The Guideline Development Group For Diagnosing And Managing Disseminated Histoplasmosis Among People Living With Hiv
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
advanced HIV disease
AIDS
Antigens
Antiretroviral therapy
Central nervous system
Communication
diagnosis
Disease
Drug dosages
Drug resistance
Drug therapy
guidelines
Histoplasma
Histoplasmosis
HIV
Human immunodeficiency virus
Immune status
Induction therapy
Infections
Itraconazole
Mortality
Nervous system
Opportunist infection
Systematic review
Tuberculosis
World Health Organization (WHO)
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Summary:Histoplasmosis is a frequent fungal opportunistic infection in people living with HIV (PLHIV), associated every year to a total of 5% to 15% of AIDS-related deaths among this population. In 2020, the first global guidelines for diagnosing and managing disseminated histoplasmosis among PLHIV was published. This document recommends (1) detection of circulating antigens as the recommended laboratory assay to diagnose histoplasmosis among PLHIV; (2) the use of liposomal amphotericin for induction therapy in severe or moderately severe disease, followed by a maintenance therapy with itraconazole for 12 months; a shorter maintenance therapy could be considered if the patient is clinically stable and if immune status has improved; (3) antiretroviral therapy initiation as soon as possible among patients with histoplasmosis without involvement of central nervous system; and (4) that for the treatment of co-infection with histoplasmosis and tuberculosis (TB), treatment of TB should be initiated according to the World Health Organization treatment guidelines. Appropriate health education of providers, supportive supervision, and policy guidance for the care of PLHIV are required.
ISSN:2309-608X
2309-608X
DOI:10.3390/jof7020134