Asymptomatic cryptococcal antigen prevalence detected by lateral flow assay in hospitalised HIV-infected patients in Sao Paulo, Brazil
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Citações na Scopus
28
Tipo de produção
article
Data de publicação
2016
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY-BLACKWELL
Autores
TONIOLO, Carolina
PAULINO, Adriana
COLOMBO, Arnaldo
MARTINS, Marilena dos Anjos
MEIRA, Cristina da Silva
PEREIRA-CHIOCCOLA, Vera Lucia
FIGUEIREDO-MELLO, Claudia
BARROS, Tiago
DUARTE, Jequelie
Citação
TROPICAL MEDICINE & INTERNATIONAL HEALTH, v.21, n.12, p.1539-1544, 2016
Resumo
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.
Palavras-chave
Cryptococcus, cryptococcal meningitis, cryptococcal screening, HIV/AIDS, cryptococcal polysaccharide, prevalence
Referências
- Linares Barandiaran L, 2012, 18 C INT SOC HUM AN
- Beyene T, 2013, PLOS ONE, V8, DOI 10.1371/journal.pone.0075585
- French N, 2002, AIDS, V16, P1031, DOI 10.1097/00002030-200205030-00009
- Frola C, 2015, 17 C AS PAN INF QUIT
- Harrison TS, 2009, AIDS, V23, P531, DOI 10.1097/QAD.0b013e328322ffc3
- Jarvis JN, 2010, BMC INFECT DIS, V10, DOI 10.1186/1471-2334-10-67
- Kaplan JE, 2015, JAIDS-J ACQ IMM DEF, V68, pS331, DOI 10.1097/QAI.0000000000000484
- Meya David, 2015, Curr Trop Med Rep, V2, P81
- Meya DB, 2010, CLIN INFECT DIS, V51, P448, DOI 10.1086/655143
- Negroni R., 1995, Revista do Instituto de Medicina Tropical de Sao Paulo, V37, P385, DOI 10.1590/S0036-46651995000500002
- Park BJ, 2009, AIDS, V23, P525, DOI 10.1097/QAD.0b013e328322ffac
- Rajasingham R, 2015, AM J TROP MED HYG, V92, P274, DOI 10.4269/ajtmh.14-0452
- Rajasingham R, 2012, JAIDS-J ACQ IMM DEF, V59, pE85, DOI 10.1097/QAI.0b013e31824c837e
- Vidal JE, 2013, BRAZ J INFECT DIS, V17, P353, DOI [10.1016/j.bjid.2012.10.020, 10.1016/bjid.2012.10.020]
- Vidal JE, 2012, DIAGN MICR INFEC DIS, V73, P68, DOI 10.1016/j.diagmicrobio.2012.01.014
- WHO Guidelines Approved by the Guidelines Review Committee, 2011, RAP ADV DIAGN PREV M