Asymptomatic cryptococcal antigen prevalence detected by lateral flow assay in hospitalised HIV-infected patients in São Paulo, Brazil
Trop. med. int. health
; 21(12): 1539-1544, Dec. 2016. tab
Article
in English
| Sec. Est. Saúde SP, SESSP-IIERPROD, Sec. Est. Saúde SP
| ID: biblio-1021745
Responsible library:
BR31.1
Localization: BR31.1; 2016_P-028
ABSTRACT
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/ll.METHODS:
Hospitalised HIV-infected patients were prospectively recruited at Instituto de Infectologia Emilio Ribas, a tertiary referral hospital to HIV-infected patients serving the S~ao 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/ll. 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, 129) years. 26% were antiretroviral (ART)-naive, and 74% were ARTexperienced. The median CD4 cell count was 25 (range, 1192) cells/ll. Five patients (3.1%; 95%CI, 1.07.0%) 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 São 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/ll, regardless of ART status. Whole blood CRAG LFA screening seems to be a simple strategy to prevention of symptomatic meningitis
Full text:
Available
Collection:
National databases
/
Brazil
Health context:
SDG3 - Health and Well-Being
/
SDG3 - Target 3.3 End transmission of communicable diseases
Health problem:
Target 3.3: End transmission of communicable diseases
/
Meningitis
Database:
Sec. Est. Saúde SP
/
SESSP-IIERPROD
Main subject:
HIV Infections
/
Meningitis, Cryptococcal
/
Cryptococcus
Type of study:
Prevalence study
/
Risk factors
Limits:
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Trop. med. int. health
Year:
2016
Document type:
Article
Institution/Affiliation country:
Fundação Fiocruz/BR
/
Secretaria de Estado da Saúde. São Paulo/BR
/
Universidade Federal de São Paulo/BR
/
University of Minnesota/US