Aids on Trinidad

Bartholomew, Courtenay; Changal, Raju; Patrick, A; Penco, Ferdinand; Jankey, N

doi:10.1016/s0140-6736(84)90029-1

Cited by 38 publications

(3 citation statements)

References 11 publications

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“…These reports rapidly increased across the United States in endemic and non-endemic areas alike 24,25 . In addition, patients from around the world were reported from areas where histoplasmosis had been rarely or never reported such as Trinidad 26 , Thailand 27 , and the Democratic Republic of Congo 28 . By 1990, Wheat and colleagues noted >100 cases of histoplasmosis in persons with AIDS, 29 and although many came from Indiana, a sizeable minority were from areas outside of traditional endemic zones.…”

Section: Global Histoplasmosis and The Advent Of Aidsmentioning

confidence: 99%

Histoplasmosis Infections Worldwide: Thinking Outside of the Ohio River Valley

et al. 2015

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In the United States, histoplasmosis is generally thought to occur mainly in the Ohio and Mississippi River Valleys, and the classic map of histoplasmosis distribution reflecting this is second nature to many U.S. physicians. With the advent of the HIV pandemic reports of patients with progressive disseminated histoplasmosis and AIDS came from regions of known endemicity, as well as from regions not thought to be endemic for histoplasmosis throughout the world. In addition, our expanding armamentarium of immunosuppressive medications and biologics has increased the diagnosis of histoplasmosis worldwide. While our knowledge of areas in which histoplasmosis is endemic has improved, it is still incomplete. Our contention is that physicians should consider histoplasmosis with the right constellations of symptoms in any febrile patient with immune suppression, regardless of geographic location or travel history.

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Section: Global Histoplasmosis and The Advent Of Aidsmentioning

confidence: 99%

Histoplasmosis Infections Worldwide: Thinking Outside of the Ohio River Valley

et al. 2015

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“…Due to the PDH form recognized by clinicians, reports about this disease came from across the world in places where histoplasmosis had been rarely or never present: Thailand, where this disease is observed almost exclusively among HIV-infected patients as this country is facing a high HIV prevalence (1253 cases reported from 1984 to 2010) [31,32], Trinidad (only two cases also in HIV men) [33], and the Democratic Republic of Congo [18]. These reports of HIV patients are proving to be very useful in order to identify previously unrecognized areas where histoplasmosis could generate different forms of disease.…”

Section: Epidemiologymentioning

confidence: 99%

HIV-Associated Histoplasmosis

Cernat¹

2023

Infectious Diseases

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Impaired immunity induced by HIV is one of the main causes of disseminated histoplasmosis in endemic areas, and thus from 1987 WHO and then the CDC classified this condition as an AIDS-defining illness. Host factors associated independently with histoplasmosis are low level of CD4 (<150 cell/mm3) and CD8 count, low nadir CD4, male gender, the absence of cART, the absence of systemic antifungals, and history of herpes simplex infection. Dissemination of an exogenously new acquired infection or reinfection and reactivation of a latent infection are both described in HIV-infected patients. Also, inflammatory reconstitution disease following cART initiation is possible. Acute pulmonary infection is rare, and only in HIV-infected patients with CD4 > 200 cell/mm3. In advanced disease, the most frequent manifestation is as disseminated histoplasmosis often acute and severe, with complications such as respiratory failure, circulatory shock, and disseminated intravascular coagulation. The subacute presentation is frequent, associated with moderate involvement of the reticuloendothelial system, with great variability of clinical manifestation. Guidelines for diagnosing and managing histoplasmosis among people living with HIV have been published from WHO, IDSA, NIH, but limited data was based on randomized clinical trials.

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“…HIV infection with very low CD4 counts in endemic areas leads to disseminated histoplasmosis [8]. Reports of histoplasmosis in AIDS emerged from areas in parts of the world where histoplasmosis had previously seldom or never been reported, such as Trinidad [9], Thailand [10] and the Democratic Republic of Congo [11]. The identification of cases in supposedly non-endemic and entirely novel regions as a consequence of the HIV epidemic, assisted in the realization that Hcc was far more widespread than initially thought [12].…”

Section: Introductionmentioning

confidence: 99%

Mapping histoplasmosis in South East Asia – implications for diagnosis in AIDS

Baker

Setianingrum

Wahyuningsih

et al. 2019

Emerging Microbes & Infections

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Histoplasmosis caused by the fungus Histoplasma capsulatum is often lethal in patients with AIDS. Urine antigen testing is highly sensitive and much quicker for diagnosis than culture. Histoplasmosis has a patchy and incompletely appreciated distribution around the world especially in South East Asia. We conducted a systematic literature review of cases of all disease forms of histoplasmosis in SE Asia, not including the Indian sub-continent. We also reviewed all histoplasmin skin test mapping studies to determine localities of exposure. We found a total of 407 cases contracted or likely to have been contracted in SE Asia. Numbers of cases by country varied: Thailand (233), Malaysia (76), Indonesia (48) and Singapore (21), with few or no cases reported in other countries. Most cases (255 (63%)) were disseminated histoplasmosis and 177 (43%) cases were HIV associated. Areas of high histoplasmin skin test sensitivity prevalence were found in Myanmar, the Philippines, Indonesia, Thailand and Vietnam - 86.4%, 26.0%, 63.6%, 36.0% and 33.7%, respectively. We have drawn maps of these data. Further study is required to ascertain the extent of histoplasmosis within SE Asia. Diagnostic capability for patients with HIV infection is urgently required in SE Asia, to reduce mortality and mis-diagnosis as tuberculosis.

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Aids on Trinidad

Cited by 38 publications

References 11 publications

Histoplasmosis Infections Worldwide: Thinking Outside of the Ohio River Valley

Histoplasmosis Infections Worldwide: Thinking Outside of the Ohio River Valley

HIV-Associated Histoplasmosis

Mapping histoplasmosis in South East Asia – implications for diagnosis in AIDS

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