2018
DOI: 10.1371/journal.pntd.0006802
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Abstract: IntroductionDisseminated histoplasmosis, a disease that often resembles and is mistaken for tuberculosis, is a major cause of death in patients with advanced HIV disease. Histoplasma antigen detection tests are an important addition to the diagnostic arsenal for patients with advanced HIV disease and should be considered for inclusion on the World Health Organization Essential Diagnostics List.ObjectiveOur objective was to systematically review the literature to evaluate the diagnostic accuracy of Histoplasma … Show more

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Cited by 47 publications
(43 citation statements)
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“…PCRs have been developed in French Guiana, but the lack of commercially available kits, the lack of standardized methods, and the limited number of validation studies are the current limitations in performing histoplasma PCR [52][53][54]. However, in the near future, a simple test allowing a rapid diagnosis on easily obtainable samples (urine, blood) should emerge with the expected availability of a high performance antigen test (Histoplasma galactomannan single-monoclonal-antibody sandwich ELISA) [55,56]. Until these become available, antigenic tests of Aspergillus based on the detection of galactomannan in serum as surrogate marker can be used [57][58][59].…”
Section: Diagnosismentioning
confidence: 99%
“…PCRs have been developed in French Guiana, but the lack of commercially available kits, the lack of standardized methods, and the limited number of validation studies are the current limitations in performing histoplasma PCR [52][53][54]. However, in the near future, a simple test allowing a rapid diagnosis on easily obtainable samples (urine, blood) should emerge with the expected availability of a high performance antigen test (Histoplasma galactomannan single-monoclonal-antibody sandwich ELISA) [55,56]. Until these become available, antigenic tests of Aspergillus based on the detection of galactomannan in serum as surrogate marker can be used [57][58][59].…”
Section: Diagnosismentioning
confidence: 99%
“…Histoplasma galactomannan detection by radio immune assay was the first antigen detection test developed by MiraVista Diagnostics, which was subsequently modified as an EIA. A polyclonal EIA developed by CDC and a IMMY monoclonal EIA also have demonstrated accuracies similar to the EIA MiraVista Diagnostics . A meta‐analysis performed in 2016 to evaluate the diagnostic performance of these tests, demonstrated that the overall sensitivity for antigen detection in serum and urine was 81%, while specificity was 99% .…”
Section: Discussionmentioning
confidence: 99%
“…With the arrival of new Histoplasma antigen detection methods, [9][10][11] the possibility of screening for histoplasma, analogous to screening for cryptococcus [3], raises a new and important research question: should we screen all patients with less than 200 CD4 for histoplasmosis? Primary prophylaxis is in practice rarely implemented perhaps because of the fear of drug-drug interactions, antifungal resistance selection, and because physicians often expect that antiretroviral therapy will quickly restore immunity.…”
Section: Discussionmentioning
confidence: 99%