Increased mortality among HIV infected patients with cryptococcal antigenemia in Guinea-Bissau

Cryptococcal antigenemia may precede development of cryptococcal meningitis and death among patients with advanced HIV infection. Among 200 retrospectively and randomly selected ART-naïve patients with CD4 counts < 100 cells/μl from Guinea-Bissau, 20 (10%) had a positive cryptococcal antigen test...

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Bibliographic Details
Published in:The Pan African medical journal 2018, Vol.29 (18), p.18-18
Main Authors: Thomsen, Ditte, Hviid, Cecilie Juul, Hønge, Bo Langhoff, Medina, Candida, Té, David Da Silva, Correira, Faustino Gomes, Østergaard, Lars, Erikstrup, Christian, Wejse, Christian, Laursen, Alex Lund, Jespersen, Sanne
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adult
AIDS
AIDS-Related Opportunistic Infections - diagnosis
AIDS-Related Opportunistic Infections - microbiology
antigen screening
Antigens, Fungal - blood
CD4 Lymphocyte Count
cryptococcal antigenemia
cryptococcal meningitis
Cryptococcus - isolation & purification
Female
Follow-Up Studies
Guinea-Bissau
HIV
HIV Infections - complications
Hospitals
Human immunodeficiency virus
Humans
Infections
Laboratories
lateral flow assay
Male
Meningitis
Meningitis, Cryptococcal - diagnosis
Mortality
Retrospective Studies
Short Communication
Sociodemographics
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Summary:Cryptococcal antigenemia may precede development of cryptococcal meningitis and death among patients with advanced HIV infection. Among 200 retrospectively and randomly selected ART-naïve patients with CD4 counts < 100 cells/μl from Guinea-Bissau, 20 (10%) had a positive cryptococcal antigen test. Self-reported headache and fever were predictors of a positive test, while cryptococcal antigenemia was a strong predictor of death within the first year of follow-up, MRR 2.22 (95% CI: 1.15-4.30). Screening for cryptococcal antigenemia should be implemented for patients with advanced HIV in Guinea-Bissau. Pre-emptive anti-fungal therapy should be initiated prior to ART-initiation if the screening is positive.
ISSN:1937-8688
1937-8688
DOI:10.11604/pamj.2018.29.18.14099