Asymptomatic cryptococcal antigen prevalence detected by lateral flow assay in hospitalised HIV-infected patients in Sao Paulo, Brazil

被引：30

作者：

Vidal, Jose E. ^{[1
,2
,3
]}

Toniolo, Carolina ^{[1
]}

Paulino, Adriana ^{[1
]}

Colombo, Arnaldo ^{[4
]}

Martins, Marilena dos Anjos ^{[5
]}

Meira, Cristina da Silva ^{[5
]}

Pereira-Chioccola, Vera Lucia ^{[5
]}

Figueiredo-Mello, Claudia ^{[1
,6
]}

Barros, Tiago ^{[1
]}

Duarte, Jequelie ^{[1
]}

Fonseca, Fernanda ^{[1
]}

Cunha, Mirella Alves ^{[1
]}

Mendes, Clara ^{[1
]}

Ribero, Taiana ^{[1
]}

Lazera, Marcia dos Santos ^{[7
]}

Rajasingham, Radha ^{[8
]}

Boulware, David R. ^{[8
]}

机构：

[1] Inst Infectol Emilio Ribas, Sao Paulo, Brazil

[2] Univ Sao Paulo, Hosp Clin, Fac Med, Sao Paulo, Brazil

[3] Univ Sao Paulo, Inst Med Trop, Sao Paulo, Brazil

[4] Univ Fed Sao Paulo, Sao Paulo, Brazil

[5] Adolfo Lutz Inst, Sao Paulo, Brazil

[6] Fac Ciencias Med Santa Casa Sao Paulo, Sao Paulo, Brazil

[7] Fundacao Fiocruz, Inst Nacl Doencas Infecciosas, Rio De Janeiro, Brazil

[8] Univ Minnesota, Minneapolis, MN USA

来源：

TROPICAL MEDICINE & INTERNATIONAL HEALTH | 2016年 / 21卷 / 12期

关键词：

Cryptococcus; cryptococcal meningitis; cryptococcal screening; HIV/AIDS; cryptococcal polysaccharide; prevalence; MENINGITIS; BURDEN;

D O I：

10.1111/tmi.12790

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

objective To determine the prevalence of asymptomatic cryptococcal antigen (CRAG) using lateral flow assay (LFA) in hospitalised HIV-infected patients with CD4 counts < 200 cells/mu l. methods Hospitalised HIV-infected patients were prospectively recruited at Instituto de Infectologia Emilio Ribas, a tertiary referral hospital to HIV-infected patients serving the Sao Paulo State, Brazil. All patients were > 18 years old without prior cryptococcal meningitis, without clinical suspicion of cryptococcal meningitis, regardless of antiretroviral (ART) status, and with CD4 counts < 200 cells/mu l. Serum CRAG was tested by LFA in all patients, and whole blood CRAG was tested by LFA in positive cases. results We enrolled 163 participants of whom 61% were men. The duration of HIV diagnosis was a median of 8 (range, 1-29) years. 26% were antiretroviral (ART)-naive, and 74% were ARTexperienced. The median CD4 cell count was 25 (range, 1-192) cells/mu l. Five patients (3.1%; 95% CI, 1.0-7.0%) were asymptomatic CRAG-positive. Positive results cases were cross-verified by performing LFA in whole blood. conclusions 3.1% of HIV-infected inpatients with CD4 < 200 cells/ll without symptomatic meningitis had cryptococcal antigenemia in Sao Paulo, suggesting that routine CRAG screening may be beneficial in similar settings in South America. Our study reveals another targeted population for CRAG screening: hospitalised HIV-infected patients with CD4 < 200 cells/mu l, regardless of ART status. Whole blood CRAG LFA screening seems to be a simple strategy to prevention of symptomatic meningitis.

引用

页码：1539 / 1544

页数：6

共 16 条

[1] Comparison of Cryptococcal Antigenemia between Antiretroviral Naive and Antiretroviral Experienced HIV Positive Patients at Two Hospitals in Ethiopia [J].