ArticleMedicine2014
Histoplasmosis in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS): multicenter study of outcomes and factors associated with relapse.
Article in Medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Treating progressive disseminated histoplasmosis in people living with HIV.The Cochrane database of systematic reviews · 2020Pooled it
- Histoplasmosis in Immunocompromised and Immunocompetent Patients in Guadeloupe.Journal of fungi (Basel, Switzerland) · 2025Article
- Practical Guidance for Clinical Microbiology Laboratories: Antibody and antigen detection methods for dimorphic fungal infections.Clinical microbiology reviews · 2025Review
- Pulmonary Histoplasmosis in People Living with Human Immunodeficiency Virus in French Guiana: Clinical Epidemiology, Medical Imaging and Prognostic.Mycopathologia · 2023Article
- The Current and Future States of Diagnostic Tests for Histoplasmosis with a Focus on People with HIV and Disseminated Histoplasmosis.Journal of fungi (Basel, Switzerland) · 2023Review
- Tackling Histoplasmosis Infection in People Living with HIV from Latin America: From Diagnostic Strategy to Public Health Solutions.Journal of fungi (Basel, Switzerland) · 2023Review
- Factors related to mortality in critically ill histoplasmosis: a multicenter retrospective study in Guadeloupe and French Guyana.Annals of intensive care · 2023Article
- Pulmonary Histoplasmosis: A Clinical Update.Journal of fungi (Basel, Switzerland) · 2023Review
- Nasal cartilage destruction associated to cutaneous histoplasmosis in AIDS.BMC infectious diseases · 2022Article
- Validation of a Lateral Flow Assay for Rapid Diagnosis of Histoplasmosis in Advanced HIV Disease, Buenos Aires, Argentina.Applied microbiology (Basel, Switzerland) · 2022Article
- Progressive disseminated histoplasmosis in children living with HIV: a case series study.European journal of pediatrics · 2021Article
- Treatment and Prevention of Histoplasmosis in Adults Living with HIV.Journal of fungi (Basel, Switzerland) · 2021Review
- Summary of Guidelines for Managing Histoplasmosis among People Living with HIV.Journal of fungi (Basel, Switzerland) · 2021Article
- How I perform hematopoietic stem cell transplantation on patients with a history of invasive fungal disease.Blood · 2020Article
- Primary Central Nervous System Infection by Histoplasma in an Immunocompetent Adult.Mycopathologia · 2020Article
- HIV-Associated Histoplasmosis: Current Perspectives.HIV/AIDS (Auckland, N.Z.) · 2020Review
- Article
- Miliary Histoplasmosis in a Patient with Rheumatoid Arthritis.Case reports in medicine · 2018Article
- Laboratory Diagnostics for Histoplasmosis.Journal of clinical microbiology · 2017Review
- Endemic Mycoses: What's New About Old Diseases?Current clinical microbiology reports · 2016Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although discontinuation of suppressive antifungal therapy for acquired immunodeficiency syndrome (AIDS)-associated histoplasmosis is accepted for patients with immunologic recovery, there have been no published studies of this approach in clinical practice, and minimal characterization of individuals who relapse with this disease. We performed a multicenter retrospective cohort study to determine the outcome in AIDS patients following discontinuation of suppressive antifungal therapy for histoplasmosis. Ninety-seven patients were divided into a physician-discontinued suppressive therapy group (PD) (38 patients) and a physician-continued suppressive therapy group (PC) (59 patients). The 2 groups were not statistically different at baseline, but at discontinuation of therapy and at the most recent follow-up there were significant differences in adherence to therapy, human immunodeficiency virus (HIV) RNA, and urinary Histoplasma antigen concentration. There was no relapse or death attributed to histoplasmosis in the PD group compared with 36% relapse (p < 0.0001) and 5% death (p = 0.28) in the PC group. Relapse occurred in 53% of the nonadherent patients but not in the adherent patients (p < 0.0001). Sixty-seven percent of patients with initial central nervous system (CNS) histoplasmosis relapsed compared to 15% of patients without CNS involvement (p = 0.0004), which may be accounted for by nonadherence. In addition, patients with antigenuria above 2.0 ng/mL at 1-year follow-up were 12.82 times (95% confidence interval, 2.91-55.56) more likely to relapse compared to those with antigenuria below 2.0 ng/mL. Discontinuation of antifungal therapy was safe in adherent patients who completed at least 1 year of antifungal treatment, and had CD4 counts >150 cells/mL, HIV RNA <400 c/mL, Histoplasma antigenuria <2 ng/mL (equivalent to <4.0 units in second-generation method), and no CNS histoplasmosis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.