Prevalence of cryptococcal infection among advanced HIV patients in Argentina using lateral flow immunoassay

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dc.contributor.authorFrola, Claudia
dc.contributor.authorGuelfand, Liliana
dc.contributor.authorBlugerman, Gabriela
dc.contributor.authorSzyld, Edgardo
dc.contributor.authorKaufman, Sara
dc.contributor.authorCahn, Pedro
dc.contributor.authorSued, Omar
dc.contributor.authorPérez, Héctor
dc.date.accessioned2024-05-23T23:50:08Z
dc.date.available2024-05-23T23:50:08Z
dc.date.issued2017-06-15
dc.descriptionFil: Frola C. Fundación Huésped, Buenos Aires; Argentinaes_ES
dc.descriptionFil: Szyld E. Fundación Huésped, Buenos Aires; Argentinaes_ES
dc.descriptionFil: Cahn P. Fundación Huésped, Buenos Aires; Argentinaes_ES
dc.descriptionFil: Sued O. Fundación Huésped, Buenos Aires; Argentinaes_ES
dc.description.abstractBackground Globally, Latin America ranks third among regions with most cases of AIDS related cryptococcal meningitis. In 2009, a lateral flow immunoassay (LFA) for the detection of cryptococcal antigen (CrAg) was developed as a potential point-of-care test for diagnosis of cryptococcal infection. In 2011 World Health Organizations recommended on CrAg screening for HIV positive persons with CD4 below 100 cells/μL, followed by preemptive fluconazole treatment. However, in Argentina no formal recommendations for CrAg screening have been issued. Methods HIV positive patients > = 18 years with advanced immunosuppression (CD4 counts ≤100 cells/μL within 3 months or WHO stage III/IV), who visited the hospital between April 1, 2014 and January 31, 2015, were included. The LFA was performed according to the manufacturer’s instructions on all serum samples. When CrAg detection was positive, a lumbar puncture was performed to rule out cryptococcal meningitis. Patients without evidence of meningeal involvement were treated with preemptive oral fluconazole in ambulatory care. Results We included 123 patients. Prevalence of CrAg-positivity was 8.1%. Among the 10 CrAg-positive patients, 6 had meningeal involvement detected through the CSF analysis (CSF India-ink testing, CSF CrAg and culture). The remaining 4 patients with positive CrAg received targeted preemptive treatment with oral fluconazole and were free of cryptococcal disease during the follow-up period. None of the 113 patients with a negative CrAg test result developed cryptococcal disease. Conclusions This is the first study in Argentina, to our knowledge, describing the prevalence of cryptococcosis and usefulness of CrAg screening. LFA provided early diagnosis to determine a high prevalence of CrAg in our hospital, and that screening for subclinical infection with preemptive antifungal treatment, prevented a substantial proportion of meningeal disease.es_ES
dc.formatapplication/pdfes_ES
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0178721
dc.identifier.urihttps://repositorio.huesped.org.ar/handle/123456789/1421
dc.languageENGes_ES
dc.provenancePublishedes_ES
dc.relation.ispartofseriesPLoS ONE;Jun 15;12(6):e0178721
dc.rightsopenAccesses_ES
dc.subjectMeningitis, Cryptococcales_ES
dc.subjectHIVes_ES
dc.subjectArgentinaes_ES
dc.titlePrevalence of cryptococcal infection among advanced HIV patients in Argentina using lateral flow immunoassayes_ES
dc.typeArticuloes_ES

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