Grant: Projet de recherche clinique ANRS
Prevalence of invasive fungal infection –Histoplasma spp., Talaromyces marneffei, Cryptococcus spp.- in severe immunocompromised HIV-infected patients in Cambodia (FUNgi-Cam)
Histoplasmosis, talaromycosis and cryptococcosis are serious invasive fungal infections in patients with advanced HIV disease. Even though these pathogens are probably endemic in Cambodia, little or no data is available, especially for histoplasmosis and talaromycosis. The lack of awareness of these infections and the insufficient availability of reliable diagnostic methods lead to delayed diagnosis. This result in a late introduction of specific treatment, which leads to an excessive burden. In the last years, antigenic and molecular methods have emerged as promising tools for the rapid diagnosis of invasive fungal infections. Our main objective is to assess, using these new methods, the prevalence of these invasive fungal infections in patients with advanced HIV disease in Cambodia. Our main secondary objective is to raise awareness and train local actors on these infections and new and simple diagnosis tools.
We will use the STATIS biobank, a study of the diagnostic management of tuberculosis in 199 severely immunocompromised HIV-positive patients in Cambodia. We will first perform specific antigenic tests for each pathogen. As the cross-reactivity of these tests between histoplasmosis and talaromycosis is unknown, we will confirm positive results by specific quantitative PCR. We will organize a laboratory workshop to train a team in the use of the test and to develop a training program, and a clinical workshop for clinicians in charge of patients at risk of invasive fungal infections in Phnom Penh hospitals.
This project will provide the first data on the prevalence of histoplasmosis and talaromycosis in patients with advanced HIV disease in Cambodia. This study will also raise awareness among local actors of these differential diagnoses of tuberculosis as well as the existence of coinfections. Training local teams in new diagnostic methods will allow further research into this public health problem, including prospective studies of invasive fungal infections in Cambodia.
PI Nord: Aude STURNY LECLERE (IP Paris)
PI Sud: Dr. Sokleaph CHENG (IP Cambodia)
Equipe B: Sokleaph CHENG, Samrach HAN, Soda MENG (Institut Pasteur Cambodge).
Equipe C: Antoine ADENIS, Ugo FRANCOISE (CIC INSERM & CH Cayenne).
Equipe D: Nathalie DE REKENEIRE, Dim BUNNET, Sovann NHOUENG, Sovandarith PIN (Institut Pasteur Cambodge).