{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:03:12Z","timestamp":1790413392326,"version":"4.1.0"},"reference-count":52,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["Edital Universal, Processo 435146\/2018-1"],"award-info":[{"award-number":["Edital Universal, Processo 435146\/2018-1"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003810","name":"Hospital de Cl\u00ednicas de Porto Alegre","doi-asserted-by":"publisher","award":["Fundo de Incentivo a Pesquisa - Projeto 2019-0493"],"award-info":[{"award-number":["Fundo de Incentivo a Pesquisa - Projeto 2019-0493"]}],"id":[{"id":"10.13039\/501100003810","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Infection"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Histoplasmosis is the second most frequent granulomatous disease in patients treated with tumor necrosis factor (TNF)-\u03b1 inhibitors, second only to tuberculosis. However, there is limited information about pre-therapy screening procedures and the need for preventive treatments for patients who will start immunobiologicals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a cohort study that evaluated the prevalence of histoplasmosis in asymptomatic HIV-negative patients before initiation of TNF-\u03b1 inhibitors by testing for Histoplasma antigen in urine samples. The patients included completed a 180-day follow-up after the initiation of the biologics to assess the onset of symptoms suggestive of histoplasmosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>From January 2021 to December 2022, 54 patients who were prescribed a TNF-\u03b1 inhibitor agent for treating autoimmune diseases in centers in southern Brazil were included. In the screening before therapy, the prevalence of a positive urinary Histoplasma antigen test was 14.8%. None of the 54 patients developed histoplasmosis after 6\u2009months of immunobiological therapy, including the eight patients who tested positive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The prevalence of Histoplasma capsulatum infection in chronic patients may be higher than expected, but the impact of latent infection in asymptomatic patients is still uncertain, including those starting treatment with immunobiological drugs such as TNF-\u03b1 inhibitors. Our study did not identify risk factors for the diagnosis of disseminated histoplasmosis in this group, including a positive result in an antigen test performed before immunobiological therapy. To date, there is no evidence to recommend routine antigen-based screening or preventive therapy for histoplasmosis before initiating a TNF-\u03b1 inhibitor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20499361231222134","type":"journal-article","created":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T05:28:24Z","timestamp":1704346104000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Screening with urine\n                    <i>Histoplasma<\/i>\n                    antigen test in asymptomatic patients starting TNF-alpha inhibitor therapy: a cohort study"],"prefix":"10.1177","volume":"11","author":[{"given":"Murillo M.","family":"Cipolat","sequence":"first","affiliation":[{"name":"Medical Sciences Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e9bora R. 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V.","family":"Nothaft","sequence":"additional","affiliation":[{"name":"School of Medicine, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claiton V.","family":"Brenol","sequence":"additional","affiliation":[{"name":"Medical Sciences Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa R.","family":"da Silva","sequence":"additional","affiliation":[{"name":"Molecular Biology Laboratory, Santa Casa de Misericordia de Porto Alegre, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro C.","family":"Pasqualotto","sequence":"additional","affiliation":[{"name":"Molecular Biology Laboratory, Santa Casa de Misericordia de Porto Alegre, Porto Alegre, Brazil"},{"name":"Internal Medicine Department, Universidade Federal de Ciencias da Saude de Porto 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