Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.
Asociación de Salud Integral, Guatemala City, Guatemala.
Trans R Soc Trop Med Hyg. 2024 Jun 4;118(6):391-398. doi: 10.1093/trstmh/trad104.
In Latin America, tuberculosis (TB) and histoplasmosis are two of the most frequent opportunistic infections affecting people living with human immunodeficiency virus (HIV). However, there are limited data on the clinical characteristics and outcomes of patients with concurrent TB and histoplasmosis infections.
This was a retrospective observational study to describe the clinical, epidemiological and laboratory characteristics and outcomes of 21 patients living with HIV (PLHIV) who were diagnosed with concurrent histoplasmosis and TB between 2017 and 2021 in Guatemala City, Guatemala.
Most patients were male and were newly diagnosed with HIV. All patients had advanced HIV disease (AHD). They presented with a median CD4 count of 20 cells/µl. The most common symptoms reported by the patients were fever, weight loss, cough and diarrhoea. Twelve patients died within 6 months of baseline evaluation, for a mortality rate of 57.1%.
PLHIV with concurrent TB and histoplasmosis infections are characterised by AHD, predominantly presenting with disseminated forms of these infections and with unspecific symptoms and signs. This evidence calls for early HIV and opportunistic infection screening and insights into the challenges and opportunities for the efficient diagnostic and therapeutic management of patients with AHD with concurrent histoplasmosis and TB infections.
在拉丁美洲，结核病（TB）和组织胞浆菌病是影响人类免疫缺陷病毒（HIV）感染者的两种最常见的机会性感染。然而，关于同时患有 TB 和组织胞浆菌病感染的患者的临床特征和结局的数据有限。
这是一项回顾性观察性研究，旨在描述 2017 年至 2021 年期间在危地马拉城诊断出同时患有组织胞浆菌病和结核病的 21 名 HIV 感染者（PLHIV）的临床、流行病学和实验室特征以及结局。
大多数患者为男性，且为新诊断的 HIV 感染者。所有患者均患有晚期 HIV 疾病（AHD）。他们的中位 CD4 计数为 20 个细胞/µl。患者报告的最常见症状是发热、体重减轻、咳嗽和腹泻。12 名患者在基线评估后 6 个月内死亡，死亡率为 57.1%。
同时患有 TB 和组织胞浆菌病感染的 PLHIV 以 AHD 为特征，主要表现为这些感染的播散形式，且症状和体征不具特异性。这一证据呼吁对 HIV 和机会性感染进行早期筛查，并深入了解 AHD 患者同时患有组织胞浆菌病和 TB 感染的诊断和治疗管理的挑战和机遇。
