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Usefulness of Serum as a Non-Invasive Sample for the Detection of Histoplasma capsulatum Infections: Retrospective Comparative Analysis of Different Diagnostic Techniques and Quantification of Host Biomarkers

Summary

This study evaluated how well different blood tests can detect histoplasmosis, a serious fungal infection caused by Histoplasma capsulatum. Researchers compared three types of tests: those detecting fungal antigens, those detecting antibodies the body produces against the fungus, and DNA-based tests. They found that the best test depends on whether the patient’s immune system is functioning normally or is weakened by HIV, and using a combination of tests provides the most reliable diagnosis. The study also identified specific immune markers in the blood that are elevated in infected patients, which could help predict disease severity.

Background

Histoplasmosis diagnosis is challenging and requires rapid, sensitive, and specific methods. Serum is a non-invasive and easily obtainable sample in clinical settings. H. capsulatum is recognized as a high-priority pathogen by WHO due to its public health importance and disease burden.

Objective

To evaluate the usefulness of serum as a non-invasive sample for diagnosing histoplasmosis using different diagnostic techniques. The study assessed the performance of antibody detection, antigen detection, and DNA-based methods, and analyzed cytokine and biomarker profiles in different patient populations.

Results

GM EIA showed 87.5% sensitivity in disseminated HIV patients and 54.5% in immunocompetent patients. ID Fungal Antibody System detected 90.9% of immunocompetent and 62.5% of HIV patients. RT-PCR showed 44% sensitivity in HIV versus 27% in non-HIV patients. Combination of techniques improved detection. H. capsulatum-infected patients showed elevated IL-8, IL-6, IL-1β, TNF-α, IL-18, PTX3, and sTREM1 levels.

Conclusion

Serum is suitable for rapid histoplasmosis diagnosis, but diagnostic technique performance depends on clinical presentation and immune status. GM EIA is suitable for disseminated histoplasmosis in HIV patients; ID technique is valuable for immunocompetent patients. Combination of techniques provides optimal performance. Elevated inflammatory biomarkers in HIV patients may predict poor prognosis and disseminated disease.
  • Published in:Journal of Fungi (Basel),
  • Study Type:Retrospective Comparative Analysis,
  • Source: 10.3390/jof11060448, PMID: 40558960
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