ArticlePLOS global public health2023
Cost-effectiveness evaluation of routine histoplasmosis screening among people living with advanced HIV disease in Latin America and the Caribbean.
Article in PLOS global public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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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.
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Who cites it
11 citing papers in PubMed, 15 citations in OpenAlex.
- Burden and Challenges in the Diagnosis and Treatment of Histoplasmosis Among Persons With Advanced HIV Disease in Uganda, 2025.Open forum infectious diseases · 2026Article
- Histoplasmosis: a missing piece in the global efforts to end HIV deaths.The lancet. HIV · 2026Review
- Histoplasma antigen detection: A laboratory-based retrospective review of routine testing from 2021 to 2023.Biomedica : revista del Instituto Nacional de Salud · 2026Article
- Research priorities for advanced HIV disease in Latin America and the Caribbean region: a modified Delphi study.Journal of the International AIDS Society · 2026Article
- Article
- Impact of the introduction of a package of care involving early detection of opportunistic infections, a prospective multicenter cohort study of people living with HIV/AIDS in Brazil.Lancet regional health. Americas · 2025Article
- Access to diagnostic testing for invasive fungal diseases and other opportunistic infections in Mexican health care centers caring for patients living with HIV.BMC health services research · 2025Article
- Implementation of Antigen-Based Diagnostic Assays for Detection of Histoplasmosis and Cryptococcosis among Patients with Advanced HIV in Trinidad and Tobago: A Cross-Sectional Study.Journal of fungi (Basel, Switzerland) · 2024Article
- Auranofin is active against Histoplasma capsulatum and reduces the expression of virulence-related genes.PLoS neglected tropical diseases · 2024Article
- Implementation of a rapid diagnostic assay package for cryptococcosis, histoplasmosis and tuberculosis in people living with HIV in Paraguay.BMC infectious diseases · 2024Article
- Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 6 countries.
Funding
Abstract
Histoplasma antigen can be detected in people with advanced HIV disease (AHD), allowing for early and accurate diagnosis of histoplasmosis. The aim of this analysis was to assess the cost-effectiveness of routine histoplasmosis screening using antigen detection, among people with AHD. We developed a decision analytic model to evaluate Histoplasma antigen screening among people with AHD. The model estimated the costs, effectiveness, and cost-effectiveness of routine screening for Histoplasma antigen compared to the current practice of no routine Histoplasma antigen screening. The model includes stratification by symptoms of histoplasmosis, severity of presentation, and estimates of 30-day mortality. Data sources were taken from the Pan American Health Organization (PAHO) Strategic Fund databases on public purchases of medicines, and published literature on treatment outcomes. Outcome measures are life years saved (LYS), costs (US dollars), and incremental cost-effectiveness ratios (ICERs). Routine Histoplasma antigen screening avoids an estimated 17% of deaths in persons with advanced HIV disease, and is cost-effective compared to no histoplasmosis screening, with an ICER of $26/LYS. In sensitivity analysis assuming treatment for histoplasmosis with liposomal amphotericin, Histoplasma antigen screening remains cost-effective with an ICER of $607/LYS. Histoplasma antigen screening among people with AHD is a cost-effective strategy and could potentially avert 17% of AIDS-related deaths. Prospective evaluation of histoplasmosis screening is warranted to determine effectiveness and treatment outcomes with this strategy.
Identifiers
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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.