Photo Credit: Kateryna Kon

The following is a summary of “Fungal biomarkers in HIV-associated disseminated histoplasmosis: a multicenter diagnostic accuracy study on the Guiana shield,” published in the December 2024 issue of Infectious Disease by Moussiegt et al. 

Researchers conducted a retrospective study to compare the diagnostic performances of (1→3)-β-D-Glucan (BDG) and Aspergillus galactomannan (GM) antigen for HIV-associated histoplasmosis.  

They performed a diagnostic accuracy study using frozen primary serum samples from consecutive hospitalized people living with HIV (PLWH). The samples were tested blindly for BDG using Fungitell® and for (GM) using PlateliaTM Aspergillus.  

The results showed that 121 sera were included, comprising 92 HIV-associated histoplasmosis cases and 29 negative controls. At thresholds of 150 pg/mL and 0.5 for BDG and GM, sensitivity and specificity were as follows: 95% [85-100] vs 90% [77-100] for BDG, and 52% [34-70] vs 83% [69-97] for GM. The ROC curves indicated AUC values of 0.82 [0.68-0.91] for BDG and 0.92 [0.80-0.98] for GM. Post-test probabilities showed optimal performance at the lowest thresholds for a negative result with both BDG and GM and at the 0.7 thresholds for a positive GM test.  

Investigators concluded the negative BDG might rule out histoplasmosis, and GM showed the best diagnostic performance among the tested biomarkers, although it was inferior to commercial antigen tests and might be considered an alternative in resource-limited settings.   

Source: ijidonline.com/article/S1201-9712(24)00435-1/fulltext