Publication: The role of serum cryptococcal antigen screening for the early diagnosis of cryptococcosis in HIV-infected patients with different ranges of CD4 cell counts
Issued Date
2010-06-01
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ISSN
01634453
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2-s2.0-77953325710
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Infection. Vol.60, No.6 (2010), 474-477
Suggested Citation
Pannee Pongsai, Kalayanee Atamasirikul, Somnuek Sungkanuparph The role of serum cryptococcal antigen screening for the early diagnosis of cryptococcosis in HIV-infected patients with different ranges of CD4 cell counts. Journal of Infection. Vol.60, No.6 (2010), 474-477. doi:10.1016/j.jinf.2010.03.015 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/29637
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Title
The role of serum cryptococcal antigen screening for the early diagnosis of cryptococcosis in HIV-infected patients with different ranges of CD4 cell counts
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Abstract
Objective: To determine the role of serum cryptococcal antigen (SCA) for the screening of cryptococcosis in HIV-infected patients with different ranges of CD4 cell counts. Methods: A retrospective cohort study was conducted in antiretroviral-naïve HIV-infected patients who had no symptom and had been screened with SCA in a tertiary-care hospital. Prevalence of positive SCA at different ranges of CD4 cell counts, risk factor of positive SCA, and incidence of cryptococcosis during one-year follow-up period after negative SCA were determined. Results: There were 131 patients with a mean age of 38.5 years; 61.8% were male. Median (range) CD4 was 62 (3-590) cells/mm3. The overall prevalence of positive SCA was 9.2%. This prevalence in patients with CD4 < 100, 100-199, and ≥200 cells/mm3were 12.9%, 3.6%, and 0%, respectively (P = 0.041). In multivariate analysis, CD4 < 100 cells/mm3was associated with positive SCA (OR = 6.69; 95% CI, 1.03-23.56). Four (33.3%) of 12 patients with positive SCA had cryptococcosis whereas one (0.8%) of 119 patients with negative SCA developed meningitis at one-year follow-up. Conclusions: SCA screening has a substantial role for the early detection of cryptococcal infection in HIV-infected patients with low CD4 cell counts. Routine screening with SCA should be performed in patients with CD4 < 100 cells/mm3. © 2010 The British Infection Society.