Should we perform the serum cryptococcal antigen test in people living with HIV hospitalized due to a community-acquired pneumonia episode?
Community-acquired pneumonia (CAP) is a common cause of hospitalization among people living with human immunodeficiency virus (PLWH), particularly those with severe immunosuppression. Pulmonary disease due to cryptococcosis is uncommonly reported and likely under-diagnosed. There is scarce informati...
| Publicado en: | International Journal of STD & AIDS Vol. 31; no. 4; pp. 345 - 351 |
|---|---|
| Autores principales: | , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Sage Publications Inc.
Mar2020
|
| 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=142064130&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 142064130 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09564624 8O9 jtl: International Journal of STD & AIDS issn: 09564624 maglogo: Y pubinfo: dt: Mar2020 vid: 31 iid: 4 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 142064130 142064130 146268325 NLM32089092 142064130 10.1177/0956462419847161 NLM32089092 142064130 ppf: 345 ppct: 6 formats: tig: atl: Should we perform the serum cryptococcal antigen test in people living with HIV hospitalized due to a community-acquired pneumonia episode? aug: au: Silva, Adriana Paulino Zenatti, Carolina Toniolo Figueiredo-Mello, Claudia Negra, Marinella Della Levin, Anna S Boulware, David R Vidal, José Ernesto affil: Deparment of Infectious Diseases, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil sug: subj: Meningitis, Cryptococcal Complications Cryptococcosis Microbiology Pneumonia Epidemiology HIV Infections Complications Antigens, Fungal Blood Lung Diseases, Fungal Microbiology Adult Community-Acquired Infections Epidemiology Middle Age Lung Diseases, Fungal Diagnosis Brazil Pneumonia Complications Cryptococcosis Diagnosis Meningitis, Cryptococcal Diagnosis AIDS-Related Opportunistic Infections Blood Female AIDS-Related Opportunistic Infections Diagnosis AIDS-Related Opportunistic Infections Microbiology Pneumonia Diagnosis Male Cryptococcosis Blood Cryptococcus Prevalence Community-Acquired Infections Microbiology Antigens, Fungal Immunology Human Funding Source Randomized Controlled Trials Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Community-acquired pneumonia (CAP) is a common cause of hospitalization among people living with human immunodeficiency virus (PLWH), particularly those with severe immunosuppression. Pulmonary disease due to cryptococcosis is uncommonly reported and likely under-diagnosed. There is scarce information about cryptococcal antigen (CrAg) prevalence in PLWH with CAP. The objectives of this study were to identify among PLWH who were hospitalized with CAP: (i) the prevalence of serum CrAg positivity, (ii) the proportion with asymptomatic vs. symptomatic cryptococcosis; and (iii) the prevalence of serum CrAg positivity in CD4+ T-cell count <100 cells/mm3. We performed a sub-analysis of a prospective cohort of hospitalized adults enrolled into a randomized clinical trial testing therapy for CAP. We included 202 participants who had serum CrAg testing performed. We found a 3.5% prevalence of serum CrAg-positivity overall, being higher (5.7%) in CD4+ T-cell count <100 cells/mm3. Overall, asymptomatic and symptomatic cryptococcosis were present in 2.0% and 1.5%, respectively. This study identifies a target population for CrAg testing: PLWH hospitalized with diagnosis of CAP, particularly those with CD4+ T-cell count <100 cells/mm3 where the number needed to test was 18 to detect 1 CrAg-positive person. This approach may facilitate the detection of asymptomatic cryptococcal infection and allow a timely diagnosis of symptomatic cryptococcal disease. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|