Diagnosing and Managing Disseminated Histoplasmosis Among People Living with HIV


Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America andis also reported in certain countries of Asia and Africa. It often affects people with impairedimmunity, including people living with HIV, among whom the most frequent clinical presentationis disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region.

These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV. Although the burden of disease is concentrated in the Americas, the recommendations contained within these guidelines are applicable globally. These guidelines were produced in accordance with the World Health Organization (WHO) handbook for guideline development. The Guideline Development Group elaborated the final recommendations based on systematic review of scientific literature and critical evaluation of the evidence available using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

These guidelines are intended for health-care providers, HIV program managers, policy-makers, national treatment advisory boards, and other professionals involved in caring for people who either have or may be at risk of developing disseminated histoplasmosis.

The main proposals of the INFOCU-LATAM are

  • To connect graduate students and health care workers interested in contributing to the development of local educational programs and guidelines for improving the early diagnosis and best clinical management of patients with fungal infections in our region
  • To promote and facilitate the conduction of collaborative multicenter studies delineated to understand the epidemiology of fungal infections in LATAM
  • To encourage advocacy initiatives necessary to convince health policy makers and hospital managers to provide better support to medical assistance to patients suffering from opportunistic and endemic fungal infections in our region


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  • ITS and TEF1α DNA Barcoding Databases
  • International Fungal Multi Locus Sequence Typing Database
  • Brazilian Society of Infectious Diseases