High prevalence of Cryptococcal antigenemia using a finger-prick lateral flow assay in individuals with advanced HIV disease in Santarém Municipality, Brazilian Amazon Basin
| Autor: | José E. Vidal, Francisco Oscar de Siqueira França, João Guilherme Pontes Lima Assy, Olívia Campos Pinheiro, Alisson Dos Santos Brandão, David R. Boulware, Renato do Carmo Said |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Antigens Fungal 030231 tropical medicine HIV Infections Specimen Handling Cohort Studies 03 medical and health sciences 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) Risk Factors Interquartile range Internal medicine Prevalence Humans Medicine Prospective Studies 030212 general & internal medicine Prospective cohort study High prevalence business.industry Cryptococcosis General Medicine Middle Aged medicine.disease Infectious Diseases Original Article Female Cryptococcal meningitis business Brazil Hiv disease Amazon basin |
| Zdroj: | Med Mycol |
| ISSN: | 1460-2709 1369-3786 |
| Popis: | There is scarce information about HIV-related cryptococcosis in the Brazilian Amazon basin where laboratory infrastructure is limited. The serum cryptococcal antigen (CrAg) lateral flow assay (LFA) has simplified diagnosis of cryptococcosis and is recommended for screening in advanced HIV disease. We evaluated the prevalence of cryptococcal antigenemia using finger-prick CrAg LFA in the Brazilian Amazon basin. We enrolled a prospective cohort of outpatients and hospitalized individuals with advanced HIV disease at two centers in Santarém Municipality, Northern Brazil. All individuals were 18 years old with advanced HIV disease, regardless of antiretroviral therapy (ART) status and with no prior or current history of confirmed cryptococcal meningitis. We tested CrAg LFA on finger-prick whole blood using an exact volume transfer pipette. From August 2018 to October 2019, 104 individuals were enrolled (outpatients 62 [60%] and hospitalized 42 [40%]). Median age was 38 years (interquartile range [IQR] 30-46), and 84 (81%) were male. Sixty-five (63%) individuals were ART-naïve. Prevalence of finger-prick CrAg LFA-positive was 10.6%; 95% CI, 5.4 to 18.1%. Prevalence of finger-prick CrAg LFA-positive among individuals without neurological symptoms was 6.0%; 95% CI, 1.7-14.6%. The number needed to test to detect one CrAg-positive individual was 9.4 persons (95% CI, 5.5-18.5). Prevalence of cryptococcal antigenemia using finger-prick whole blood CrAg LFA was high. Point-of-care approach was important for the diagnosis and screening of cryptococcosis in resource-limited settings. Screening and preemptive therapy strategy should be urgently implemented in individuals with advanced HIV disease in the Brazilian Amazon basin.This prospective cohort study was carried-out in the Brazilian Amazon basin. We used a cryptococcal rapid test in patients with AIDS. We included 104 participants, and 11 (10.6%) of them had positive results showing a high prevalence of cryptococcal antigenemia. |
| Databáze: | OpenAIRE |
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