Histoplasma capsulatum Not Detected in People with HIV and Systemic Symptoms in Port-au-Prince, Haiti.

When local epidemiology of endemic fungal infections is poorly understood, it is difficult to determine the clinical impact of screening for these pathogens in people living with HIV. We found no Histoplasma urine antigen or serum antibody in over 450 symptomatic patients with a new diagnosis of HIV in Port-au-Prince, Haiti. These findings indicate that systematic testing is likely to be low yield in Port-au-Prince, although it is well described in other countries in the region, and may have higher prevalence in rural areas. These findings are relevant to other settings where the prevalence of histoplasmosis is poorly defined, as similar studies could also inform local evidence-based guidelines.