Identification of Cryptococcus antigen in human immunodeficiency virus-positive Turkish patients by using the Dynamiker® lateral flow assay.
Mycoses
; 62(10): 961-968, 2019 Oct.
Article
em En
| MEDLINE
| ID: mdl-31344286
ABSTRACT
Cryptococcus neoformans causes life-threatening meningoencephalitis, particularly in human immunodeficiency virus (HIV)-positive individuals with low CD4 levels (<100 cells/µL). Although the burden of cryptococcal meningoencephalitis (CM) in Turkey is low (0.13 cases per 100 000 persons), asymptomatic individuals at risk of cryptococcosis should be screened for antigenemia to prevent the disease and/or promote early CM diagnosis. A lateral flow assay (LFA) is used to detect Cryptococcus antigen (CrAg) in cerebrospinal fluid and serum. We determined Cryptococcus antigenemia prevalence in serum samples of HIV-positive and HIV-negative adult patients by using Dynamiker® CrAg-LFA, a point-of-care dipstick test. Patients' demographic data, CD4 count, HIV-RNA levels and anti-retroviral therapy status were recorded. CrAg was detected in 28 (11%) of 254 HIV-positive patients screened but not in 100 HIV-negative control individuals; a significant difference was observed in the CrAg-LFA positivity rate between HIV-positive and HIV-negative groups (x2 = 11.970; P < .05). In CrAg-positive patients, the median CD4 level was 666 cells/µL (115-1344 cells/µL), with a median viral load of 23 copies/mL (0-3.69 × 106 copies/mL). In HIV-positive CrAg-negative patients, the median CD4 level was 633 cells/µL (31-2953 cells/µL) and the median viral load was 12 copies/mL (0-1.95 × 106 copies/mL; P > .05). Results indicate that HIV-positive patients with both low (<200 cells/µL) and high (>200 cells/µL) CD4 counts should be screened for asymptomatic cryptococcal antigenemia. HIV-associated asymptomatic cryptococcosis is not uncommon in Turkey, which warrants systematic screening. Updated strategies for CM prevention among HIV-positive patients should be used even in non-endemic countries.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
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4_TD
Base de dados:
MEDLINE
Assunto principal:
Imunoensaio
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Infecções por HIV
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Criptococose
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Testes Diagnósticos de Rotina
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Antígenos de Fungos
Tipo de estudo:
Diagnostic_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Mycoses
Ano de publicação:
2019
Tipo de documento:
Article