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Access to diagnostic testing for invasive fungal diseases and other opportunistic infections in Mexican health care centers caring for patients living with HIV

Summary

This study examined the availability of diagnostic tests for fungal and other serious infections in Mexican HIV clinics. Researchers found that most clinics, especially smaller primary care facilities, lack modern rapid testing equipment needed to quickly diagnose dangerous infections like cryptococcosis and histoplasmosis. These infections are common in people with advanced HIV and can be life-threatening, making access to rapid diagnosis crucial for treatment and survival.

Background

Opportunistic infections remain a significant burden among people living with HIV (PLWH) in Mexico despite improvements in mortality worldwide. Invasive fungal diseases contribute to approximately 50% of mortality in PLWH. Local data on laboratory capacities for diagnosing opportunistic infections in Mexico is lacking.

Objective

To report the current access to diagnostics for opportunistic infections in Mexican Health Care Centers offering services to PLWH, including identification of advanced HIV disease and availability of diagnostic tools for fungal and other opportunistic infections.

Results

46 centers from 23 states responded, serving 67,003 PLWH. Less than 50% could perform CD4+ T cell count (39%), toxoplasma serology (41%), or HIV viral load (41%). Only 54% could diagnose cryptococcosis and tuberculosis, while 24% had access to aspergillosis or Histoplasma tests. Primary care centers, despite serving more advanced disease patients, had significantly fewer diagnostic resources than tertiary centers.

Conclusion

Most Mexican public HIV-dedicated health care centers lack on-site capacity to diagnose opportunistic infections, particularly fungal infections. Rapid and point-of-care tests are frequently unavailable, especially in primary care facilities, despite their critical importance for patient outcomes in advanced HIV disease.
  • Published in:BMC Health Services Research,
  • Study Type:Cross-sectional Survey,
  • Source: PMID: 39966809, DOI: 10.1186/s12913-025-12405-5
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