Cryptococcal Antigenemia in HIV-Infected Patients with CD4+ T-cell Count ≤ 200 cells/μl: A study from a tertiary care hospital

Introduction: Cryptococcal meningitis is one of the leadingopportunistic infections associated with high mortality. Thepresent study was carried out to determine the prevalence ofcryptococcal antigenemia in HIV-infected patients with CD4+T-cell count ≤ 200 cells/μl.Material and methods: A cross-sectional study includinga total of 100 blood samples of HIV-infected patients withCD4+ T-cell count ≤ 200 cells/μl was carried out in a tertiarycare hospital. The Cryptococcal Antigen Latex AgglutinationTest was performed on serum separated from blood samplesincluded in the study group. A positive cryptococcalantigenemia was diagnosed by positive latex agglutinationtest of cryptococcal polysaccharide antigen in serum. BMI ofall patients included in the study group was calculated andWHO clinical staging of all patients was noted.Results: Three cases out of 100 were positive for cryptococcalantigenemia. The positive cases showed correlation with lowBMI and WHO Clinical stage II and III of HIV disease. Inthe present study, 33.33% and 66.67% of positive cases hadCD4+ T-cell count within the range of 0-100cells/μl and101-200cells/μl respectively.Conclusion: It is important to implement routine screeningfor cryptococcal antigen among HIV-infected cases withCD4+ T-cell count ≤ 200 cells/μl for early detection ofcryptococcal antigenemia. It will help in identifying the riskof subsequent cryptococcal meningitis and initiation of preemptive antifungal treatment.

Role of IgM specific indirect immunofluorescence assay in diagnosing an outbreak of leptospirosis.

The study was conducted during a suspected epidemic of leptospirosis in Maharashtra. A total of 13 acute phase blood samples, collected at 5-6 days from the onset of symptoms, and 10 convalescent phase samples, colected at around 20 days from the onset of symptoms were obtained from 13 patients. Sera were separated and the samples were subjected to Microagglutination Test (MAT) and IgM-Indirect Immunofluorescence assay (IFA) to detect antibodies against leptospira. In the acute phase sera, only one sample was positive by MAT while seven were positive by IFA. In the convalescent samples, six were positive by MAT and seven were positive by IFA. IFA is a rapid test and can be used for early diagnosis of leptospirosis.