Bibliographic Info
GuidelineWHO guidelines on the management of advanced HIV disease
Year of Publication2025
Issuing InstitutionWorld Health Organization
Recommendation
Status
Maintained
Recommended in favor
Conditional
Certainty of evidence
Very low
Treating mild to moderate histoplasmosis among people living with HIV: itraconazole 200 mg three times daily for three days and then 200 mg twice daily is recommended
Notes and Remarks
- 1.Access to optimal antifungal medicines The WHO Model List of Essential Medicines includes optimal antifungal medicines for treating people with histoplasmosis (conventional amphotericin B and itraconazole). Increased advocacy for drug price reduction is needed, expanding coverage of the global access price of liposomal amphotericin B for leishmaniasis and cryptococcal meningitis, promoting local manufacturing of generic formulations. Additionally, it is important to ensure quality assurance of available generic formulations, ensuring national registration of all antifungal drugs on the WHO Model List of Essential Medicines. Medicines can be procured through joint regional procurement mechanisms such as the PAHO Strategic Fund, ensuring adequate supply chains at the national level and developing proper drug forecasting and monitoring systems.
- 2.Educating and training health-care providers Health-care providers should be trained to have a low threshold for suspecting histoplasmosis among people living with HIV, especially in advanced HIV disease, with the differential diagnosis of TB and other systemic fungal infections. Greater efforts need to be made to educate health-care providers and to provide policy guidance at the national level on managing histoplasmosis among people living with HIV. Effectively implementing guidelines also requires supportive supervision systems and prescribing decision-making aids.
Also Featured In
This recommendation also appears in the following guidelines:
Originally Developed
Guideline
Guidelines for Diagnosing and Managing Disseminated Histoplasmosis among People Living with HIV
Year2020
InstitutionPan American Health Organization
Guideline
Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach
Year2021
InstitutionWHO