{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:32:23Z","timestamp":1792798343726,"version":"4.5.0"},"reference-count":30,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,5]],"date-time":"2024-10-05T00:00:00Z","timestamp":1728086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CDC-PAHO Agreement","award":["6 NU50CK000494-01-04"],"award-info":[{"award-number":["6 NU50CK000494-01-04"]}]},{"name":"CDC-PAHO Agreement","award":["CDC-RFA-CK18-1801CONT20"],"award-info":[{"award-number":["CDC-RFA-CK18-1801CONT20"]}]},{"name":"Funding Opportunity Announcement","award":["6 NU50CK000494-01-04"],"award-info":[{"award-number":["6 NU50CK000494-01-04"]}]},{"name":"Funding Opportunity Announcement","award":["CDC-RFA-CK18-1801CONT20"],"award-info":[{"award-number":["CDC-RFA-CK18-1801CONT20"]}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JoF"],"abstract":"<jats:p>The Caribbean continues to have high HIV prevalence globally with concurrently high mortality rates due to opportunistic Infections. This study addresses the prevalence of histoplasmosis and cryptococcosis among patients living with advanced HIV disease (AHD) in Trinidad and Tobago, focusing on the implementation of antigen-based diagnostic assays. Conducted as a cross-sectional survey across five HIV treatment sites, 199 participants with advanced HIV disease were enrolled between July 2022 and September 2023. Diagnostic testing was performed using the Clarus Histoplasma Galactomannan Enzyme Immunoassay (EIA), and the Immy CrAg\u00ae LFA Cryptococcal Antigen Lateral Flow Assay on urine and blood samples, respectively. Results revealed that 14.6% of participants were found to be co-infected with either histoplasmosis or cryptococcosis, with histoplasmosis being more prevalent (10.5%) than cryptococcosis (4.0%). The study found no significant demographic differences between newly diagnosed and previously diagnosed participants. However, a lower median CD4 count was associated with a higher risk of fungal opportunistic infections. The findings underscore the critical role of systematic use of fungal antigen-based diagnostic assays among patients with AHD to improve the timely diagnosis and treatment of fungal infections among people living with HIV in resource-limited settings and to improve patient outcomes and survival.<\/jats:p>","DOI":"10.3390\/jof10100695","type":"journal-article","created":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T07:30:18Z","timestamp":1728286218000},"page":"695","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Implementation of Antigen-Based Diagnostic Assays for Detection of Histoplasmosis and Cryptococcosis among Patients with Advanced HIV in Trinidad and Tobago: A Cross-Sectional Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0966-4861","authenticated-orcid":false,"given":"Ayanna","family":"Sebro","sequence":"first","affiliation":[{"name":"National AIDS Coordinating Committee, Office of the Prime Minister, Port of Spain 190126, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5334-821X","authenticated-orcid":false,"given":"Jonathan","family":"Edwards","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Coordinating Unit Ministry of Health, Port of Spain 101002, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5818-770X","authenticated-orcid":false,"given":"Omar","family":"Sued","sequence":"additional","affiliation":[{"name":"Department of Communicable Diseases Prevention, Control, and Elimination, Pan American Health Organization, Washington, DC 20037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon-Omari","family":"Lavia","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Coordinating Unit Ministry of Health, Port of Spain 101002, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tricia","family":"Elder","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Coordinating Unit Ministry of Health, Port of Spain 101002, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4392-8998","authenticated-orcid":false,"given":"Robert Jeffrey","family":"Edwards","sequence":"additional","affiliation":[{"name":"Medical Research Foundation, 7 Queens Park East, Port of Spain 101002, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick Eberechi","family":"Akpaka","sequence":"additional","affiliation":[{"name":"Department of Paraclinical Sciences, The University of the West Indies, St. Augustine 330912, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Ram-Bhola","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Coordinating Unit Ministry of Health, Port of Spain 101002, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roanna","family":"Morton-Williams Bynoe","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Coordinating Unit Ministry of Health, Port of Spain 101002, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9212-1560","authenticated-orcid":false,"given":"Yanink","family":"Caro-Vega","sequence":"additional","affiliation":[{"name":"Departamento de Infectolog\u00eda, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Tlalpan, M\u00e9xico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isshad","family":"John","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Coordinating Unit Ministry of Health, Port of Spain 101002, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2001-0057","authenticated-orcid":false,"given":"Freddy","family":"Perez","sequence":"additional","affiliation":[{"name":"Department of Communicable Diseases Prevention, Control, and Elimination, Pan American Health Organization, Washington, DC 20037, USA"},{"name":"Department of Community Health, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,5]]},"reference":[{"key":"ref_1","unstructured":"HIV\/AIDS JUNPo (2024). 2024 UNAIDS Global AIDS Update: The Urgency of Now: AIDS at a Crossroads, UNAIDS."},{"key":"ref_2","first-page":"195","article-title":"The HIV epidemic in the Caribbean","volume":"57","author":"Figueroa","year":"2008","journal-title":"West Indian Med. 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