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Clinical and Vaccine Immunology, June 2009, p. 852-858, Vol. 16, No. 6
1071-412X/09/$08.00+0     doi:10.1128/CVI.00066-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Development and Evaluation of an Enzyme-Linked Immunosorbent Assay To Detect Histoplasma capsulatum Antigenuria in Immunocompromised Patients{triangledown}

Christina M. Scheel,1* Blanca Samayoa,2 Alejandro Herrera,2 Mark D. Lindsley,1 Lynette Benjamin,1 Yvonne Reed,3 John Hart,3 Sandra Lima,2 Blanca E. Rivera,2 Gabriella Raxcaco,2 Tom Chiller,1 Eduardo Arathoon,2 and Beatriz L. Gómez1

Division of Foodborne, Bacterial and Mycotic Diseases,1 Division of Scientific Resources, Centers for Disease Control and Prevention, Atlanta, Georgia,3 Clinica Familiar Luis Angel Garcia, Hospital General San Juan de Dios, Guatemala City, Guatemala2

Received 12 February 2009/ Returned for modification 17 March 2009/ Accepted 3 April 2009

Histoplasma capsulatum infection causes significant morbidity and mortality in human immunodeficiency virus-infected individuals, particularly those in countries with limited access to rapid diagnostics or antiretroviral therapies. The fungus easily disseminates in persons with AIDS, resulting in progressive disseminated histoplasmosis (PDH), which can progress rapidly to death if undiagnosed. The availability of a simple, rapid method to detect H. capsulatum infection in less developed countries where the infection is endemic would dramatically decrease the time to diagnosis and treatment of PDH. We have developed an antigen-capture enzyme-linked immunosorbent assay (ELISA) to detect PDH antigenuria in infected patients. The assay uses polyclonal antibodies against H. capsulatum as both capture and detection reagents, and a standard reference curve is included to quantify antigenuria and ensure reproducibility. We evaluated this assay using specimens collected from patients with AIDS and culture-proven histoplasmosis in a Guatemalan clinic (n = 48), from healthy persons (n = 83), and from patients with other, nonhistoplasmosis diseases (n = 114). The ELISA demonstrated a sensitivity of 81% and a specificity of 95% in detecting H. capsulatum antigen in urine. This assay relies on simple technology that can be performed in institutions with limited resources. Use of this test will facilitate rapid diagnosis of PDH in countries where mortality is high, expediting treatment and likely reducing PDH-related mortality.

* Corresponding author. Mailing address: Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop G-11, Atlanta, GA 30333. Phone: (404) 639-3126. Fax: (404) 639-3546. E-mail: cscheel{at}cdc.gov

{triangledown} Published ahead of print on 8 April 2009.

Clinical and Vaccine Immunology, June 2009, p. 852-858, Vol. 16, No. 6
1071-412X/09/$08.00+0     doi:10.1128/CVI.00066-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Munoz, C., Gomez, B. L., Tobon, A., Arango, K., Restrepo, A., Correa, M. M., Muskus, C., Cano, L. E., Gonzalez, A. (2010). Validation and Clinical Application of a Molecular Method for Identification of Histoplasma capsulatum in Human Specimens in Colombia, South America. CVI 17: 62-67 [Abstract] [Full Text]  


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