2025/06/19 by Julián Andrés Hoyos-Pulgarín, Germán A. Gómez, M. Otero +2 · 1 voice
Medicine · #Fungal Infections and Studies #HIV-related health complications and treatments #HIV/AIDS oral health manifestations
paper · pdf · doi:10.1093/ofid/ofaf355
openalex publication_date 2025/06/19 · openalex created_date 2025/06/28 · openalex updated_date 2026/07/30
Abstract Background Disseminated histoplasmosis is more common in patients with impaired immune function, with HIV infection being a recognized risk factor for its development. In this patient group, diagnosis poses a challenge due to the nonspecific clinical picture. We aimed to develop a diagnostic predictive scale for disseminated histoplasmosis in patients with HIV. Methods We analyzed records from 2 tertiary institutions in the city of Pereira between May 2014 and December 2022. We selected 313 cases of HIV: 90 patients were diagnosed with histoplasmosis and 223 with other opportunistic infections. Results Variables associated with the diagnosis of histoplasmosis were hemoglobin <10 g/dL (odds ratio [OR], 2.0; 95% CI, 1.0–4.2; P = .039), leukopenia (OR, 2.2; 95% CI, 1.1–4.2; P = .019), elevated lactate dehydrogenase (OR, 2.2; 95% CI, 1.0–4.5; P = .034), an aspartate transaminase/alanine transaminase ratio >2 (OR, 3.8; 95% CI, 2.0–7.4; P < .001), and a CD4+ lymphocyte count <50 cells/μL (OR, 2.4; 95% CI, 1.2–4.6; P = .011). With these parameters, a diagnostic predictive scale was developed. With a cutoff of ≥4 points, it correctly classified 76.7% of cases with a sensitivity of 62.3% and a specificity of 82.9%, with adequate accuracy demonstrated by an area under the receiver operating characteristic curve of 78%. Conclusions This study proposes a simple and cost-effective tool that facilitates timely diagnosis and treatment of histoplasmosis in patients with HIV.