P461 Cryptococcosis screening and isolates characterization in asymptomatic people living with HIV in Kinshasa, DRC

Autor: Bive Zono, Rosalie Sacheli, Hippolyte Situakibanza Nani-Tuma, Alphonse Mavanga, Justin Anyshayi Mwambi, Mamie Etondo, Dacquin Muhandwa Kasumba, Michel Moutschen, Georges Mvumbi Lelo, Marie-Pierre Hayette
Rok vydání: 2022
Předmět:
Zdroj: Medical Mycology. 60
ISSN: 1460-2709
1369-3786
DOI: 10.1093/mmy/myac072.p461
Popis: Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objectives Cryptococcal meningitis (CM) is a life-threatening invasive mycosis affecting people living with HIV (PLHIV) and has a high prevalence and case fatality rate in sub-Saharan Africa. While most PLHIV presenting CM are symptomatic, the asymptomatic ones are diagnosed following routine screening tests indicated for all advanced PLHIV (CD4 Methods We performed cross-sectional screening for serum cryptococcal antigen (CrAg) in ambulant PLHIV with Results A total of 47 PLHIV out of 262 included were tested positive for serum CrAg (19%, 95% CI: 14.2–24.3) from which 46.8% (22/47) had a high antigenic titer (≥1/160). The prevalence of asymptomatic CM was then estimated at 50% in CrAg serum-positive patients who consented to lumbar puncture (19/38). Although the female proportion included in the study was higher than that of men, serum CrAg was more positive in men (21.4%, 18/84 men included) than in women (18.0%, 29/161 women included). While the mean CD4 count of CrAg serum-positive patients were significantly lower than that of negative patients (P .05). Only four CSF samples were positive in culture for Cryptococcus spp. and were all characterized as Cryptococcus neoformans/serotype A. At this stage, two isolates have been analyzed using the ISHAM MLST scheme and two different sequence type (ST) profiles were identified, namely: ST93 and ST63. While ST93 is the main Cryptococcus neoformans profile described in Congolese (DRC) PLHIV with CM, ST63 has not yet been identified in the DRC before. Of note, epidemiological and clinical specificities of ST63 have so far been poorly characterized in the literature. Susceptibility testing against the major antifungals and the MLST typing of the two remaining strains are still ongoing. Conclusions The prevalence of cryptococcosis should not be neglected among asymptomatic PLHIV in the DRC, to meaning that screening and preventive treatment measures should be integrated into the national policy for HIV management and related diseases. For the rest of the analyses still in progress, conclusions can only be drawn once they have been fully finalized.
Databáze: OpenAIRE
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