Open AccessDevelopment and Evaluation of an Enzyme-Linked Immunosorbent Assay To DetectHistoplasma capsulatumAntigenuria in Immunocompromised Patients
Author(s) -
Christina M. Scheel,
Blanca Samayoa,
Alejandro Herrera,
Mark D. Lindsley,
Lynette Benjamin,
Yvonne Reed,
John Hart,
Sergio Monteiro Lima,
Blanca E. Rivera,
Gabriella Raxcaco,
Tom Chiller,
Eduardo Arathoon,
Beatriz L. Gómez
Publication year - 2009
Publication title -
clinical and vaccine immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.649
H-Index - 77
eISSN - 1556-6811
pISSN - 1556-679X
DOI - 10.1128/cvi.00066-09
Subject(s) - histoplasmosis , histoplasma , fungemia , immunology , medicine , virology , antigen , polyclonal antibodies , antibody , biology , mycosis , histoplasma capsulatum
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 detectH. 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 againstH. 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 detectingH. 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.