The role of serum cryptococcal antigen screening for the early diagnosis of cryptococcosis in HIV-infected patients with different ranges of CD4 cell counts - 07/08/11
Corresponding author. Tel.: +66 2 2011581; fax: +66 2 2012232.Summary |
Objective |
To determine the role of serum cryptococcal antigen (SCA) for the screening of cryptococcosis in HIV-infected patients with different ranges of CD4 cell counts.
Methods |
A retrospective cohort study was conducted in antiretroviral-naïve HIV-infected patients who had no symptom and had been screened with SCA in a tertiary-care hospital. Prevalence of positive SCA at different ranges of CD4 cell counts, risk factor of positive SCA, and incidence of cryptococcosis during one-year follow-up period after negative SCA were determined.
Results |
There were 131 patients with a mean age of 38.5 years; 61.8% were male. Median (range) CD4 was 62 (3–590) cells/mm3. The overall prevalence of positive SCA was 9.2%. This prevalence in patients with CD4 < 100, 100–199, and ≥200 cells/mm3 were 12.9%, 3.6%, and 0%, respectively (P = 0.041). In multivariate analysis, CD4 < 100 cells/mm3 was associated with positive SCA (OR = 6.69; 95% CI, 1.03–23.56). Four (33.3%) of 12 patients with positive SCA had cryptococcosis whereas one (0.8%) of 119 patients with negative SCA developed meningitis at one-year follow-up.
Conclusions |
SCA screening has a substantial role for the early detection of cryptococcal infection in HIV-infected patients with low CD4 cell counts. Routine screening with SCA should be performed in patients with CD4 < 100 cells/mm3.
Le texte complet de cet article est disponible en PDF.Keywords : Serum cryptococcal antigen, Cryptococcosis, HIV, AIDS, Screening
Plan
 | Note: Abstract of this study is presented in the 5th IAS Conference on the HIV Pathogenesis, Treatment, and Prevention, Cape Town, 19–22 July 2009, Abstract TUPEB120. |
Vol 60 - N° 6
P. 474-477 - juin 2010 Retour au numéro
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