Tuberculosis and histoplasmosis among human immunodeficiency virus-infected patients: a comparative study.

Abstract : In disease-endemic areas, histoplasmosis is the main differential diagnosis for tuberculosis among human immunodeficiency virus (HIV)-infected patients. However, no study has compared the two diseases. Thus, the objective of this study was to compare tuberculosis and histoplasmosis in HIV-infected patients. A population of 205 HIV-infected patients (99 with tuberculosis and 106 with histoplasmosis) hospitalized in Cayenne, French Guiana during January 1, 1997-December 31, 2008 were selected retrospectively from the French Hospital Database on HIV. Multivariate analysis showed that tuberculosis was associated with cough (adjusted odds ratio [AOR] = 0.20, 95% confidence interval [CI] = 0.05-0.73) and a C-reactive protein level > 70 mg/L (AOR = 0.98, 95% CI = 0.97-0.99). Variables associated with disseminated histoplasmosis were a γ-glutamyl transferase level > 72 IU/L (AOR = 4.99, 95% CI = 1.31-18.99), origin from French Guiana (AOR = 5.20, 95% CI = 1.30-20.73), disseminated localization (AOR = 6.40, 95% CI = 1.44-28.45), a concomitant opportunistic infection (AOR = 6.71, 95% CI = 1.50-29.96), a neutrophil count < 2,750 cells/mm(3) (AOR = 10.54, 95% CI = 2.83-39.24), a CD4 cell count < 60 cells/mm(3) (AOR = 11.62, 95% CI = 2.30-58.63), and a platelet count < 150,000/mm(3) (AOR = 19.20, 95% CI = 3.35-110.14). Tuberculosis and histoplasmosis have similarities, but some factors show a greater association with one of these diseases. Thus, adapted therapeutic choices can be made by using simple clinical and paraclinical criteria.
Type de document :
Article dans une revue
American Journal of Tropical Medicine and Hygiene, American Society of Tropical Medicine and Hygiene, 2014, 90 (2), pp.216-23. 〈10.4269/ajtmh.13-0084〉
Liste complète des métadonnées

Littérature citée [20 références]  Voir  Masquer  Télécharger

http://www.hal.inserm.fr/inserm-01065027
Contributeur : Antoine Adenis <>
Soumis le : mercredi 17 septembre 2014 - 16:28:03
Dernière modification le : mercredi 18 juillet 2018 - 20:11:27
Document(s) archivé(s) le : vendredi 14 avril 2017 - 13:34:53

Fichiers

 Accès restreint
Fichier visible le : jamais

Connectez-vous pour demander l'accès au fichier

Identifiants

Collections

Citation

Antoine Adenis, Mathieu Nacher, Matthieu Hanf, Célia Basurko, Julie Dufour, et al.. Tuberculosis and histoplasmosis among human immunodeficiency virus-infected patients: a comparative study.. American Journal of Tropical Medicine and Hygiene, American Society of Tropical Medicine and Hygiene, 2014, 90 (2), pp.216-23. 〈10.4269/ajtmh.13-0084〉. 〈inserm-01065027〉

Partager

Métriques

Consultations de la notice

146