{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:54:54Z","timestamp":1792641294319,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T00:00:00Z","timestamp":1632873600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["1USGPS003104\u201001"],"award-info":[{"award-number":["1USGPS003104\u201001"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Histoplasmosis and cryptococcosis are important public health problems in people living with HIV (PLHIV) in Central America. Conventional laboratory tests, such as culture and microscopy, are not optimal; however, antigen (Ag) tests are rapid, highly sensitive, and specific for diagnosis of fungal opportunistic infections (OI). The aim of this study was to describe the results of a laboratory\u2010based surveillance system for histoplasmosis and cryptococcosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An observational cross\u2010sectional study based on laboratory surveillance, was carried out in two hospitals in Guatemala and one hospital in El Salvador, between July 2012 and December 2014. Diagnosis of histoplasmosis and cryptococcosis in PLHIV were performed by culture and Ag test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 160 PLHIV were diagnosed with fungal OI, of which, 96 (60%) were diagnosed with histoplasmosis, 62 (39%) were with cryptococcosis, and two patients (1%) were diagnosed with both fungal diseases. Of the 160 patients analysed in this study, 94 (59%) were diagnosed using only an Ag assay. CD4 cell count data were available for 136 (85%) patients; 127 (93%) patients had a CD4 count &lt;200; and 90 (66%) had counts &lt;50 CD4 cells per \u00b5l. Antiretroviral therapy utilisation at diagnosis was low (33%). Seventy\u2010one out of 160 (44%) were co\u2010infected with tuberculosis or other OIs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>More than half of the patients in this study were diagnosed only by rapid laboratory Ag tests. A high per cent of the patients had advanced HIV disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13368","type":"journal-article","created":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T18:54:35Z","timestamp":1631991275000},"page":"1563-1570","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Diagnosis of fungal opportunistic infections in people living with HIV from Guatemala and El Salvador"],"prefix":"10.1111","volume":"64","author":[{"given":"Diana","family":"Forno","sequence":"first","affiliation":[{"name":"Division of Global HIV &amp; TB at the Central America Regional Office for the Centers for Disease Control and Prevention (CDC) Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanca","family":"Samayoa","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n de Salud Integral Guatemala City Guatemala"},{"name":"Facultad de Ciencias Qu\u00edmicas y Farmacia Universidad de San Carlos de Guatemala Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narda","family":"Medina","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n de Salud Integral Guatemala City Guatemala"},{"name":"Clinica Familiar \u201cLuis \u00c1ngel Garc\u00eda\u201d Hospital General San Juan de Dios Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Arathoon","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n de Salud Integral Guatemala City Guatemala"},{"name":"Clinica Familiar \u201cLuis \u00c1ngel Garc\u00eda\u201d Hospital General San Juan de Dios Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Rodolfo","family":"Mejia","sequence":"additional","affiliation":[{"name":"Hospital Roosevelt Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remei","family":"Gordillo","sequence":"additional","affiliation":[{"name":"Hospital Roosevelt Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolando","family":"Cedillos","sequence":"additional","affiliation":[{"name":"Hospital Nacional Rosales San Salvador El Salvador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Rodas","sequence":"additional","affiliation":[{"name":"Division of Global HIV &amp; TB at the Central America Regional Office for the Centers for Disease Control and Prevention (CDC) Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Ahlquist Cleveland","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch CDC Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Chiller","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch CDC Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8749-9809","authenticated-orcid":false,"given":"Diego H.","family":"Caceres","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch CDC Atlanta GA USA"},{"name":"Department of Medical Microbiology Radboud University Medical Center and Center of Expertise in Mycology Radboudumc\/CWZ Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4557-4801-3.00265-4"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4557-4801-3.00264-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30243-8"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0123-9392(12)70026-7"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13326"},{"key":"e_1_2_9_7_1","unstructured":"UNAIDS.UNAIDS data 2020.2020.http:\/\/rstesa.UNAIDS.org\/documents\/country\u2010snapshots\/83\u2010unaids\u2010data\u20102020\/file. 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