Primary prevention
There are no primary prevention measures for immunocompetent patients. For young infants or patients with underlying immunosuppressive disorders, exposure to areas with a high inoculum of Histoplasma should be avoided to prevent disseminated disease. For patients with HIV/AIDS, CD4 counts <150 cells/mm³, and living in areas with an incidence of Histoplasma >10 cases per 100 patient-years, primary prophylaxis with itraconazole is recommended, although there are limited data to justify this approach.[23][24][25] In patients receiving antiretroviral therapy, primary prophylaxis with itraconazole can safely be discontinued when the patient’s HIV viral load is undetectable and the CD4 count has been ≥150 cells/mm³ for 6 months.[25]
Use of this content is subject to our disclaimer