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Clinical and laboratory profile of persons living with human immunodeficiency virus/acquired immune deficiency syndrome and histoplasmosis from a Colombian hospital

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dc.creatorCaceres, Diego H.
dc.creatorTobón, Angela M.
dc.creatorAhlquist Cleveland, Angela
dc.creatorScheel, Christina M.
dc.creatorBerbesi, Dedsy Y.
dc.creatorOchoa, Jesús
dc.creatorRestrepo, Angela
dc.creatorBrandt, Mary E.
dc.creatorChiller, Tom
dc.creatorGómez, Beatriz L.
dc.creator.googleCaceres, Diego H.spa
dc.creator.googleTobón, Angela M.spa
dc.creator.googleAhlquist Cleveland, Angelaspa
dc.creator.googleScheel, Christina M. Sspa
dc.creator.googleBerbesi, Dedsy Y.spa
dc.creator.googleOchoa, Jesússpa
dc.creator.googleRestrepo, Angelaspa
dc.creator.googleBrandt, Mary E.spa
dc.creator.googleChiller, Tomspa
dc.creator.googleGómez, Beatriz L.spa
dc.date.accessioned2020-05-12T12:40:40Z
dc.date.available2020-05-12T12:40:40Z
dc.date.created2016
dc.date.issued2016
dc.description.abstractHistoplasmosis is common among persons living with human immunodeficiency virus/acquired immune deficiency syndrome (PLWHA) in Latin America, but its diagnosis is difficult and often nonspecific. We conducted prospective screening for histoplasmosis among PLWHA with signs or symptoms suggesting progressive disseminated histoplasmosis (PDH) and hospitalized in Hospital La María in Medellín, Colombia. The study's aim was to obtain a clinical and laboratory profile of PLWHA with PDH. During 3 years (May 2008 to August 2011), we identified 89 PLWHA hospitalized with symptoms suggestive of PDH, of whom 45 (51%) had histoplasmosis. We observed tuberculosis (TB) coinfection in a large proportion of patients with PDH (35%), so all analyses were performed adjusting for this coinfection and, alternatively, excluding histoplasmosis patients with TB. Results showed that the patients with PDH were more likely to have Karnofsky score ≤ 30 (prevalence ratio [PR] = 1.98, 95% confidence interval [CI] = 0.97-4.06), liver compromised with hepatomegaly and/or splenomegaly (PR = 1.77, CI = 1.03-3.06) and elevation in serum of alanine aminotransferase and aspartate aminotransferase to values > 40 mU/mL (PR = 2.06, CI = 1.09-3.88 and PR = 1.53, CI = 0.99-2.35, respectively). Using multiple correspondence analyses, we identified in patients with PDH a profile characterized by the presence of constitutional symptoms, namely weight loss and Karnofsky classification ≤ 30, gastrointestinal manifestations with alteration of liver enzymes and hepatosplenomegaly and/or splenomegaly, skin lesions, and hematological alterations. Study of the profiles is no substitute for laboratory diagnostics, but identifying clinical and laboratory indicators of PLWHAwith PDH should allow development of strategies for reducing the time to diagnosis and thus mortality caused by Histoplasma capsulatum. Copyright © 2016 by The American Society of Tropical Medicine and Hygiene.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.4269/ajtmh.15-0837
dc.identifier.issn0002-9637
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/21983
dc.language.isoengspa
dc.relation.citationEndPage924
dc.relation.citationIssueNo. 4
dc.relation.citationStartPage918
dc.relation.citationTitleAmerican Journal of Tropical Medicine and Hygiene
dc.relation.citationVolumeVol. 95
dc.relation.ispartofAmerican Journal of Tropical Medicine and Hygiene, ISSN: 0002-9637 Vol. 95, No. 4 (2016) pp. 918-924spa
dc.relation.urihttp://www.ajtmh.org/docserver/fulltext/14761645/95/4/918.pdf?expires=1544617567&id=id&accname=guest&checksum=B99F871C91F75750FE4E185DEAEFA82Dspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectSIDAspa
dc.subject.ddcEnfermedadesspa
dc.subject.keywordAlanine aminotransferasespa
dc.subject.keywordAspartate aminotransferasespa
dc.subject.keywordLiver enzymespa
dc.subject.keywordAcquired immune deficiency syndromespa
dc.subject.keywordVIHspa
dc.titleClinical and laboratory profile of persons living with human immunodeficiency virus/acquired immune deficiency syndrome and histoplasmosis from a Colombian hospitalspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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