Cryptococcal Antigenemia in Advanced Human Immunodeficiency Virus Disease: Pathophysiology, Epidemiology, and Clinical Implications.

Cryptococcal antigen (CrAg) is detectable in blood prior to the onset of symptomatic cryptococcal meningitis (CM), a leading cause of death among people with advanced human immunodeficiency virus (HIV) disease globally. Highly sensitive assays can detect CrAg in blood, and screening people with HIV...

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Publicado en:Clinical Infectious Diseases Vol. 76; no. 4; pp. 764 - 771
Autores principales: Wake, Rachel M, Molloy, Síle F, Jarvis, Joseph N, Harrison, Thomas S, Govender, Nelesh P
Formato: algorithm pictorial review tables/charts Journal Article
Publicado: Oxford University Press / USA 2/15/2023
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Cryptococcal Antigenemia in Advanced Human Immunodeficiency Virus Disease: Pathophysiology, Epidemiology, and Clinical Implications.
      aug:
        au:
          Wake, Rachel M
          Molloy, Síle F
          Jarvis, Joseph N
          Harrison, Thomas S
          Govender, Nelesh P
        affil: Institute for Infection and Immunity, St George's University of London , London , United Kingdom
      sug:
        subj:
          HIV Infections Epidemiology
          HIV Infections Complications
          Cryptococcus Analysis
          Meningitis, Cryptococcal Physiopathology
          Meningitis, Cryptococcal Risk Factors
          Meningitis, Cryptococcal Drug Therapy
          Antibiotics, Antifungal Therapeutic Use
          Risk Assessment
          Antigens, Viral Blood
          CD4 Lymphocyte Count
          Cerebrospinal Fluid Analysis
          Meningitis, Cryptococcal Mortality
          Meningitis, Cryptococcal Etiology
          Diagnostic Services
          Health Screening
      ab: Cryptococcal antigen (CrAg) is detectable in blood prior to the onset of symptomatic cryptococcal meningitis (CM), a leading cause of death among people with advanced human immunodeficiency virus (HIV) disease globally. Highly sensitive assays can detect CrAg in blood, and screening people with HIV with low CD4 counts, followed by preemptive antifungal treatment, is recommended and widely implemented as part of a global strategy to prevent CM and end cryptococcal-related deaths. Cryptococcal antigenemia encompasses a spectrum of conditions from preclinical asymptomatic infection (cerebrospinal fluid [CSF] CrAg-negative) through subclinical (CSF CrAg-positive without overt meningism) to clinical symptomatic cryptococcal disease, usually manifesting as CM. In this review, we summarize current understanding of the pathophysiology, risk factors for, and clinical implications of cryptococcal antigenemia within this spectrum. We also provide an update on global prevalence, recommended screening and treatment strategies, and future considerations for improving outcomes among patients with cryptococcal antigenemia.
      pubtype: Academic Journal
      doctype:
        algorithm
        pictorial
        review
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      ougenre: Article
    language: English
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