{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:59:57Z","timestamp":1768399197139,"version":"3.49.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100002322","name":"CAPES","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"CNPq","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Disseminated histoplasmosis (DH) is a severe opportunistic infection in people living with HIV\/AIDS (PLWHA). We aimed to identify predictors of in-hospital death among PLWHA with DH and to assess the prognostic value of novel biomarkers. A cohort study was conducted at the S\u00e3o Jos\u00e9 Hospital of Infectious Diseases in Fortaleza, Brazil (March 2023\u2013December 2024). Sixty-one patients were included; 15 (24.6%) died during hospitalization. Mortality was strongly associated with peripheral blood detection of Histoplasma capsulatum (relative risk, RR\u00a0=\u00a05.05; 95% confidence interval, CI\u00a0=\u00a02.30\u201311.10). Several laboratory markers were also associated with death, including elevated C-reactive protein (CRP) (P\u00a0=\u00a0.001), aspartate aminotransferase (AST) (P\u00a0=\u00a0.005), direct bilirubin (P\u00a0=\u00a0.017), lactate dehydrogenase levels (P\u00a0=\u00a0.011), and hypocalcemia (P\u00a0=\u00a0.003). Severe complications\u2014renal replacement therapy (RR\u00a0=\u00a011.25; 95% CI\u00a0=\u00a03.64\u201334.80), mechanical ventilation (RR\u00a0=\u00a016.82; 95% CI\u00a0=\u00a04.23\u201366.84), and shock (RR\u00a0=\u00a033.44; 95% CI\u00a0=\u00a04.75\u2013235.72)\u2014were also linked to death. In receiver operating characteristic curve analysis, CRP exhibited the highest predictive performance (area under the curve\u00a0=\u00a00.787; 95% CI\u00a0=\u00a00.638\u20130.935), whereas Angiopoietin-2 showed the highest specificity (0.93). In the multivariate model, AST retained a trend towards an independent association with death (hazard ratio\u00a0=\u00a01.141; 95% CI 0.983\u20131.327). DH mortality remains high due to late HIV diagnosis and advanced disease. Early recognition and timely antifungal therapy are essential to improve survival.<\/jats:p>","DOI":"10.1093\/mmy\/myaf124","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T12:57:02Z","timestamp":1766581022000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical and laboratory predictors of mortality in HIV\/AIDS patients with disseminated histoplasmosis: A cohort study in a hyperendemic region of Northeast Brazil"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6117-8302","authenticated-orcid":false,"given":"Matheus Alves de Lima","family":"Mota","sequence":"first","affiliation":[{"name":"Post-Graduate Program in Medical Sciences, Department of Internal Medicine, Faculty of Medicine, Federal University of Cear\u00e1 , Fortaleza, CE 60430-140 ,","place":["Brazil"]},{"name":"S\u00e3o Jos\u00e9 Hospital of Infectious Diseases , Fortaleza, CE 60455-610 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Fortaleza, CE 60430-160 ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Let\u00edcia Machado","family":"de\u00a0Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Post-Graduate Program in Pharmacology, Federal University of Cear\u00e1 , Fortaleza, CE 60430-275 ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice Maria Costa","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Clinical and Toxicological Analyses, Federal University of Cear\u00e1 , Fortaleza, CE 60430-160 ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jac\u00f3 Ricarte","family":"Lima\u00a0de\u00a0Mesquita","sequence":"additional","affiliation":[{"name":"S\u00e3o Jos\u00e9 Hospital of Infectious Diseases , Fortaleza, CE 60455-610 ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisandra Serra","family":"Damasceno","sequence":"additional","affiliation":[{"name":"S\u00e3o Jos\u00e9 Hospital of Infectious Diseases , Fortaleza, CE 60455-610 ,","place":["Brazil"]},{"name":"Department of Community Health, Faculty of Medicine, Federal University of Cear\u00e1 , Fortaleza, CE 60430-235 ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terezinha do Menino Jesus Silva","family":"Leit\u00e3o","sequence":"additional","affiliation":[{"name":"S\u00e3o Jos\u00e9 Hospital of Infectious Diseases , Fortaleza, CE 60455-610 ,","place":["Brazil"]},{"name":"Department of Community Health, Faculty of Medicine, Federal University of Cear\u00e1 , Fortaleza, CE 60430-235 ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gdayllon Cavalcante","family":"Meneses","sequence":"additional","affiliation":[{"name":"Department of Clinical and Toxicological Analyses, Federal University of Cear\u00e1 , Fortaleza, CE 60430-160 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