Prevalence of cryptococcal antigenuria at initial HIV diagnosis in Kwa Zulu- Natal.
Objectives The World Health Organization ( WHO) recommends screening HIV-infected people for cryptococcal antigens to identify cryptococcosis, a major cause of AIDS-related deaths. As the burden of cryptococcosis is unknown in South Africa's Kwa Zulu- Natal province, we assessed the cryptococcal ant...
| Publicado en: | HIV Medicine Vol. 16; no. 10; pp. 640 - 645 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Nov2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=110426792&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 110426792 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14642662 F0I jtl: HIV Medicine issn: 14642662 maglogo: Y pubinfo: dt: Nov2015 vid: 16 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 110426792 110426792 110426792 10.1111/hiv.12263 NLM25958770 110426792 ppf: 640 ppct: 5 formats: tig: atl: Prevalence of cryptococcal antigenuria at initial HIV diagnosis in Kwa Zulu- Natal. aug: au: Drain, PK Kleene, JM Coleman, SM Losina, E Katz, JN Giddy, J Ross, D Freedberg, KA Bassett, IV affil: Massachusetts General Hospital, Boston MA, USA sug: subj: Cryptococcosis Epidemiology HIV Infections Epidemiology Cryptococcosis Urine HIV Infections Diagnosis South Africa Human Prevalence Cross Sectional Studies Outpatients Descriptive Statistics Adult Male Female Confidence Intervals Cryptococcus CD4 Lymphocyte Count Fisher's Exact Test T-Tests Mann-Whitney U Test Two-Tailed Test Data Analysis Software Funding Source Adult: 19-44 years Male Female ab: Objectives The World Health Organization ( WHO) recommends screening HIV-infected people for cryptococcal antigens to identify cryptococcosis, a major cause of AIDS-related deaths. As the burden of cryptococcosis is unknown in South Africa's Kwa Zulu- Natal province, we assessed the cryptococcal antigenuria prevalence among newly diagnosed HIV-infected adults there. Methods We conducted a cross-sectional study of newly diagnosed HIV-infected adults who received voluntary HIV testing in an out-patient clinic. Participants provided a urine specimen in a sterile container, and we performed testing with a WHO-endorsed rapid cryptococcal antigen lateral flow assay ( Immy Inc., Norman, OK, USA) per the manufacturer's specifications. We assessed cryptococcal antigenuria prevalence among participants with CD4 counts < 200 cells/μL, and stratified results by CD4 count categories. Results Among 432 participants, the mean (± standard deviation) age was 36.1 ± 9.9 years and 172 (40%) were female. The overall estimated prevalence of cryptococcal antigenuria was 9.0% [95% confidence interval ( CI) 6.5-12.1%]. CD4 counts were available for 319 participants (74%); the median CD4 count was 75 cells/μL [interquartile range ( IQR) 34-129 cells/μL]. Participants with a negative cryptococcal antigenuria screening test had a median CD4 count of 79 cells/μL ( IQR 36-129 cells/μL), while participants with a positive cryptococcal test had a median CD4 count of 41 cells/μL ( IQR 10-112 cells/μL). The estimated prevalence of cryptococcal antigenuria among participants with CD4 counts < 50 cells/μL was 12.5% (95% CI 7.0-20.1%), which was significantly higher than that among participants with CD4 counts of 50-200 cells/μL (4.8%; 95% CI 2.3-8.7%). Conclusions Nearly 1 in 10 newly diagnosed HIV-infected adults with CD4 counts < 200 cells/μL in Kwa Zulu-Natal had evidence of cryptococcal antigenuria. Point-of-care CD4 count testing and cryptococcal antigen screening may rapidly identify cryptococcosis at the time of HIV diagnosis. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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