Seroprevalence of histoplasmosis in Kampala, Uganda

Nathan C. Bahr, George A. Sarosi, David B. Meya, Paul R. Bohjanen, Sarah M. Richer, Samantha Swartzentruber, Ryan Halupnick, Deidre Jarrett, L. Joseph Wheat, David R. Boulware

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Histoplasmosis is endemic to the Midwestern United States, but cases have been reported nearly worldwide. A 1970 study found 3.8% skin test sensitivity to Histoplasma capsulatum in Uganda but no systemic study of histoplasmosis exposure has occurred since the onset of the human immunodeficiency virus (HIV) pandemic. This study investigated the seroprevalence of H. capsulatum and sought previously undetected cases of histoplasmosis in Kampala, Uganda. Serum, cerebrospinal fluid (CSF) and/or urine specimens were obtained from HIV-infected persons with suspected meningitis. Specimens were tested for H. capsulatum IgG and IgM by enzyme immune assay and Histoplasma antigen. 147 of the 257 subjects who were enrolled had cryptococcal meningitis. Overall, 1.3% (2/151) of subjects were serum Histoplasma IgG positive, and zero of 151 were IgM positive. Antigen was not detected in any serum (n = 57), urine (n = 37, or CSF (n = 63) samples. Both subjects with serum Histoplasma IgG positivity had cryptococcal meningitis. Histoplasma capsulatum IgG was detected at low levels in persons with HIV/AIDS in Kampala, Uganda. Histoplasmosis is not widespread in Uganda but microfoci do exist. There appears to be no cross-reactivity between Cryptococcus neoformans and Histoplasma antigen testing, and cryptococcosis appears to be at most, a rare cause of positive Histoplasma IgG.

Original languageEnglish (US)
Pages (from-to)295-300
Number of pages6
JournalMedical mycology
Volume54
Issue number3
DOIs
StatePublished - Jan 14 2016

Keywords

  • Diagnostic Techniques and Procedures
  • Histoplasmosis
  • Histoplasmosis capsulatum
  • Human Immunodeficiency Virus
  • Validation Studies
  • seroepidemiologic studies

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