title: How many have died from undiagnosed human immunodeficiency virus-associated histoplasmosis, a treatable disease? Time to act.
abstract: Human immunodeficiency virus (HIV)-associated disseminated Histoplasma capsulatum capsulatum infection often mimics tuberculosis. This disease is well know in the United States but is dramatically underdiagnosed in Central and South America. In the Amazon region, given the available incidence data and the regional HIV prevalence, it is expected that, every year, 1,500 cases of histoplasmosis affect HIV patients in that region alone. Given the mortality in undiagnosed patients, at least 600 patients would be expected to die from an undiagnosed but treatable disease. The lack of a simple diagnostic tool and the lack of awareness by clinicians spiral in a vicious cycle and made a major problem invisible for 30 years. The HIV/acquired immunodeficiency syndrome community should tackle this problem now to prevent numerous avoidable deaths from HIV-associated histoplasmosis in the region and elsewhere.
authors.affiliation: Centre d'Investigation Clinique Epidémiologie Clinique Antilles Guyane CIC-EC CIE 802, Cayenne General Hospital, Cayenne, French Guiana; Coordination Regionale de la Lutte Contre le VIH de Guyane, Laboratoire Hospitalo-Universitaire de Parasitologie Mycologie, Unité des Maladies Infectieuses et Tropicale, et Service de Dermatologie Vénéréologie, Centre Hospitalier de Cayenne, Cayenne, French Guiana; Equipe EPaT EA3593 Epidemiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Cayenne, French Guiana.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
authors.forename: Antoine
authors.initials: A
authors.lastname: Adenis
authors.forename: Christine
authors.initials: C
authors.lastname: Aznar
authors.forename: Denis
authors.initials: D
authors.lastname: Blanchet
authors.forename: Vincent
authors.initials: V
authors.lastname: Vantilcke
authors.forename: Magalie
authors.initials: M
authors.lastname: Demar
authors.forename: Bernard
authors.initials: B
authors.lastname: Carme
authors.forename: Pierre
authors.initials: P
authors.lastname: Couppié
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000401:mortality*; D002489:Central America / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000401:mortality*; D006658:Histoplasma / Q000254:growth & development / Q000302:isolation & purification; D006660:Histoplasmosis / Q000150:complications / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D015995:Prevalence; D013020:South America / Q000453:epidemiology; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D014481:United States / Q000453:epidemiology