Emerg Infect Dis. 2024 Aug;30(8):1523-1530. doi: 10.3201/eid3008.231710.
Histoplasmosis is a fungal disease associated with substantial mortality rates among persons with advanced HIV disease. Our systematic review synthesized data on the global prevalence of Histoplasma--caused antigenuria in persons with HIV. We searched PubMed/Medline, Embase, and Scopus databases on January 3, 2023, to identify cross-sectional and cohort studies evaluating Histoplasma antigenuria prevalence among adults with HIV infection. We calculated point estimates and 95% CIs to summarize prevalence. Of 1,294 studies screened, we included 15. We found Histoplasma antigenuria among 581/5,096 (11%; 95% CI 11%-12%) persons with HIV and 483/3,789 persons with advanced HIV disease (13%; 95% CI 12%-14%). Among persons with HIV and symptoms consistent with histoplasmosis, Histoplasma antigenuria prevalence was 14% (95% CI 13%-15%; 502/3,631 participants). We determined that persons with advanced HIV disease, inpatients, and symptomatic persons might benefit from a systematic approach to early detection of histoplasmosis using urine antigen testing.
组织胞浆菌病是一种与艾滋病毒疾病晚期患者死亡率显著相关的真菌病。我们的系统评价综合了全球艾滋病毒患者中组织胞浆菌引起的抗原尿患病率的数据。我们于 2023 年 1 月 3 日在 PubMed/Medline、Embase 和 Scopus 数据库中搜索了评估成人艾滋病毒感染者中组织胞浆菌抗原尿患病率的横断面和队列研究。我们计算了点估计值和 95%置信区间来总结患病率。在筛选出的 1294 项研究中，我们纳入了 15 项。我们发现，在 5096 名艾滋病毒感染者中有 581 人（11%；95%CI 11%-12%）和在 3789 名艾滋病毒疾病晚期患者中有 483 人（13%；95%CI 12%-14%）存在组织胞浆菌抗原尿。在有组织胞浆菌病症状的艾滋病毒感染者中，组织胞浆菌抗原尿的患病率为 14%（95%CI 13%-15%；502/3631 名参与者）。我们确定，艾滋病毒疾病晚期患者、住院患者和有症状患者可能受益于采用尿液抗原检测对组织胞浆菌病进行早期检测的系统方法。
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