A multicenter evaluation of tests for diagnosis of histoplasmosis

Chadi Hage, Julie A. Ribes, Nancy L. Wengenack, Larry M. Baddour, Maha Assi, David S. McKinsey, Kassem Hammoud, Daisy Alapat, N. Esther Babady, Michelle Parker, DeAnna Fuller, Aliya Noor, Thomas Davis, Mark Rodgers, Patricia A. Connolly, Boutros El Haddad, L. Joseph Wheat

Research output: Contribution to journalArticle

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Abstract

Background: The sensitivity of the MVista Histoplasma antigen enzyme immunoassay (MiraVista Diagnostics) has been evaluated in disseminated histoplasmosis in patients with AIDS and in the "epidemic" form of acute pneumonia. Moreover, there has been no evaluation of the sensitivity of antigenemia detection in disseminated histoplasmosis after the implementation of methods to dissociate immune complexes and denature released antibodies. The goal of this study was to determine the sensitivity of the current antigen assay in different categories of histoplasmosis. Methods: Urine and serum specimens obtained from 218 patients with histoplasmosis and 229 control subjects, including 30 with blastomycosis, were tested. Results: Antigenuria was detected in 91.8% of 158 patients with disseminated histoplasmosis, 83.3% of 6 patients with acute histoplasmosis, 30.4% of 46 patients with subacute histoplasmosis, and 87.5% of 8 patients with chronic pulmonary histoplasmosis; antigenemia was present in 100% of 31 tested cases of disseminated histoplasmosis. Among patients with disseminated cases, antigenuria was detected more often and at higher concentrations in immunocompromised patients and those with severe disease. Specificity was 99.0% for patients with nonfungal infections (n = 130) and in healthy subjects (n = 69), but cross-reactivity occurred in 90% of patients with blastomycosis. Conclusions: The sensitivity of antigen detection in disseminated histoplasmosis is higher in immunocom-promised patients than in immunocompetent patients and in patients with more severe illness. The sensitivity for detection of antigenemia is similar to that for antigenuria in disseminated infection.

Original languageEnglish
Pages (from-to)448-454
Number of pages7
JournalClinical Infectious Diseases
Volume53
Issue number5
DOIs
StatePublished - Sep 1 2011

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Histoplasmosis
Blastomycosis
Antigens
Histoplasma
Immunocompromised Host
Infection
Antigen-Antibody Complex
Immunoenzyme Techniques
Pneumonia
Healthy Volunteers
Acquired Immunodeficiency Syndrome

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Hage, C., Ribes, J. A., Wengenack, N. L., Baddour, L. M., Assi, M., McKinsey, D. S., ... Joseph Wheat, L. (2011). A multicenter evaluation of tests for diagnosis of histoplasmosis. Clinical Infectious Diseases, 53(5), 448-454. https://doi.org/10.1093/cid/cir435

A multicenter evaluation of tests for diagnosis of histoplasmosis. / Hage, Chadi; Ribes, Julie A.; Wengenack, Nancy L.; Baddour, Larry M.; Assi, Maha; McKinsey, David S.; Hammoud, Kassem; Alapat, Daisy; Esther Babady, N.; Parker, Michelle; Fuller, DeAnna; Noor, Aliya; Davis, Thomas; Rodgers, Mark; Connolly, Patricia A.; El Haddad, Boutros; Joseph Wheat, L.

In: Clinical Infectious Diseases, Vol. 53, No. 5, 01.09.2011, p. 448-454.

Research output: Contribution to journalArticle

Hage, C, Ribes, JA, Wengenack, NL, Baddour, LM, Assi, M, McKinsey, DS, Hammoud, K, Alapat, D, Esther Babady, N, Parker, M, Fuller, D, Noor, A, Davis, T, Rodgers, M, Connolly, PA, El Haddad, B & Joseph Wheat, L 2011, 'A multicenter evaluation of tests for diagnosis of histoplasmosis', Clinical Infectious Diseases, vol. 53, no. 5, pp. 448-454. https://doi.org/10.1093/cid/cir435
Hage C, Ribes JA, Wengenack NL, Baddour LM, Assi M, McKinsey DS et al. A multicenter evaluation of tests for diagnosis of histoplasmosis. Clinical Infectious Diseases. 2011 Sep 1;53(5):448-454. https://doi.org/10.1093/cid/cir435
Hage, Chadi ; Ribes, Julie A. ; Wengenack, Nancy L. ; Baddour, Larry M. ; Assi, Maha ; McKinsey, David S. ; Hammoud, Kassem ; Alapat, Daisy ; Esther Babady, N. ; Parker, Michelle ; Fuller, DeAnna ; Noor, Aliya ; Davis, Thomas ; Rodgers, Mark ; Connolly, Patricia A. ; El Haddad, Boutros ; Joseph Wheat, L. / A multicenter evaluation of tests for diagnosis of histoplasmosis. In: Clinical Infectious Diseases. 2011 ; Vol. 53, No. 5. pp. 448-454.
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abstract = "Background: The sensitivity of the MVista Histoplasma antigen enzyme immunoassay (MiraVista Diagnostics) has been evaluated in disseminated histoplasmosis in patients with AIDS and in the {"}epidemic{"} form of acute pneumonia. Moreover, there has been no evaluation of the sensitivity of antigenemia detection in disseminated histoplasmosis after the implementation of methods to dissociate immune complexes and denature released antibodies. The goal of this study was to determine the sensitivity of the current antigen assay in different categories of histoplasmosis. Methods: Urine and serum specimens obtained from 218 patients with histoplasmosis and 229 control subjects, including 30 with blastomycosis, were tested. Results: Antigenuria was detected in 91.8{\%} of 158 patients with disseminated histoplasmosis, 83.3{\%} of 6 patients with acute histoplasmosis, 30.4{\%} of 46 patients with subacute histoplasmosis, and 87.5{\%} of 8 patients with chronic pulmonary histoplasmosis; antigenemia was present in 100{\%} of 31 tested cases of disseminated histoplasmosis. Among patients with disseminated cases, antigenuria was detected more often and at higher concentrations in immunocompromised patients and those with severe disease. Specificity was 99.0{\%} for patients with nonfungal infections (n = 130) and in healthy subjects (n = 69), but cross-reactivity occurred in 90{\%} of patients with blastomycosis. Conclusions: The sensitivity of antigen detection in disseminated histoplasmosis is higher in immunocom-promised patients than in immunocompetent patients and in patients with more severe illness. The sensitivity for detection of antigenemia is similar to that for antigenuria in disseminated infection.",
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AU - McKinsey, David S.

AU - Hammoud, Kassem

AU - Alapat, Daisy

AU - Esther Babady, N.

AU - Parker, Michelle

AU - Fuller, DeAnna

AU - Noor, Aliya

AU - Davis, Thomas

AU - Rodgers, Mark

AU - Connolly, Patricia A.

AU - El Haddad, Boutros

AU - Joseph Wheat, L.

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N2 - Background: The sensitivity of the MVista Histoplasma antigen enzyme immunoassay (MiraVista Diagnostics) has been evaluated in disseminated histoplasmosis in patients with AIDS and in the "epidemic" form of acute pneumonia. Moreover, there has been no evaluation of the sensitivity of antigenemia detection in disseminated histoplasmosis after the implementation of methods to dissociate immune complexes and denature released antibodies. The goal of this study was to determine the sensitivity of the current antigen assay in different categories of histoplasmosis. Methods: Urine and serum specimens obtained from 218 patients with histoplasmosis and 229 control subjects, including 30 with blastomycosis, were tested. Results: Antigenuria was detected in 91.8% of 158 patients with disseminated histoplasmosis, 83.3% of 6 patients with acute histoplasmosis, 30.4% of 46 patients with subacute histoplasmosis, and 87.5% of 8 patients with chronic pulmonary histoplasmosis; antigenemia was present in 100% of 31 tested cases of disseminated histoplasmosis. Among patients with disseminated cases, antigenuria was detected more often and at higher concentrations in immunocompromised patients and those with severe disease. Specificity was 99.0% for patients with nonfungal infections (n = 130) and in healthy subjects (n = 69), but cross-reactivity occurred in 90% of patients with blastomycosis. Conclusions: The sensitivity of antigen detection in disseminated histoplasmosis is higher in immunocom-promised patients than in immunocompetent patients and in patients with more severe illness. The sensitivity for detection of antigenemia is similar to that for antigenuria in disseminated infection.

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