Point-of-Care Cryptococcal Antigen Screening Predicts Cryptococcal Meningitis and Mortality Among People Living with HIV in a South African Township

2019 ◽  
Author(s):  
Paul K. Drain ◽  
Sean R. Galagan ◽  
Sabina Govere ◽  
Meighan Krows ◽  
Hilary Thulare ◽  
...  
Keyword(s):  
South African ◽  
Cryptococcal Meningitis ◽  
Point Of Care ◽  
People Living With Hiv ◽  
Cryptococcal Antigen ◽  
Living With Hiv ◽  
South African Township

Prevalence of Asymptomatic Cryptococcal Antigenemia and Association with Follow-up risk of Cryptococcal Meningitis and Mortality among HIV Infected Patients in North West India – A Prospective Cohort Study

2020 ◽  
Vol 18 ◽  
Author(s):  
Rajendra Bhati ◽  
Pramendra Sirohi ◽  
Bharat Sejoo ◽  
Deepak Kumar ◽  
Gopal K Bohra ◽  
...  
Keyword(s):  
Cryptococcal Meningitis ◽  
Morbidity And Mortality ◽  
People Living With Hiv ◽  
Cryptococcal Antigen ◽  
North West ◽  
Cryptococcal Disease ◽  
Increased Risk ◽  
Living With Hiv ◽  
Inflammatory Syndrome

Objective: Cryptococcal meningitis is an important cause of morbidity and mortality in HIV infected individuals. In the era of universal antiretroviral therapy incidence of immune reconstitution inflammatory syndrome (IRIS) related cryptococcal meningitis has increased. Detection of serum cryptococcal antigen in asymptomatic PLHIV (People Living With HIV) and pre-emptive treatment with fluconazole can decrease the burden of cryptococcal disease. We conducted this study to find the prevalence of asymptomatic cryptococcal antigenemia in India and its correlation with mortality in PLHIV. Method and material: This was a prospective observational study. HIV infected ART naïve patients with age of ≥ 18 years who had CD4 counts ≤ 100 /µL were included and serum cryptococcal antigen test was done. These patients were followed for six months to look for the development of Cryptococcal meningitis and mortality. Results: A total of 116 patients were analysed. Asymptomatic cryptococcal antigenemia was detected in 5.17% patients and it correlated with increased risk of cryptococcal meningitis and mortality on follow-up in PLHIV. Conclusion: Serum cryptococcal positivity is correlated with increased risk of Cryptococcal meningitis and mortality in PLHIV. We recommend the screening of asymptomatic PLHIV with CD4 ≤ 100/µL for serum cryptococcal antigen, so that pre-emptive treatment can be initiated to reduce morbidity and mortality.

scholarly journals Community Viral Load and CD4 Count Distribution Among People Living With HIV in a South African Township

2013 ◽  
Vol 63 (4) ◽  
pp. 498-505 ◽  
Author(s):  
Katharina Kranzer ◽  
Stephen D. Lawn ◽  
Leigh F. Johnson ◽  
Linda-Gail Bekker ◽  
Robin Wood
Keyword(s):  
Viral Load ◽  
South African ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Count Distribution ◽  
Living With Hiv ◽  
South African Township

Novel High Sensitivity Tuberculosis Point-of-Care Test for People Living with HIV

2018 ◽  
Author(s):  
Tobias Broger ◽  
Bianca Sossen ◽  
Elloise du Toit ◽  
Andrew D. Kerkhoff ◽  
Charlotte Schutz ◽  
...  
Keyword(s):  
Point Of Care ◽  
High Sensitivity ◽  
People Living With Hiv ◽  
Point Of Care Test ◽  
Living With Hiv

scholarly journals The essential role of physiotherapists in providing rehabilitation services to people living with HIV in South Africa

2013 ◽  
Vol 69 (1) ◽  
Author(s):  
S. Cobbing ◽  
V. Chetty ◽  
J. Hanass-Hancock ◽  
J. Jelsma ◽  
H. Myezwa ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
Policy Formulation ◽  
People Living With Hiv ◽  
Highly Active ◽  
Hiv Epidemic ◽  
Wide Range ◽  
Living With Hiv ◽  
Education Courses

Despite increased access to highly active anti-retroviral therapy (HAART) in South Africa, there remains a high risk of people living with HIV (PLHIV) developing a wide range of disabilities. Physiotherapists are trained to rehabilitate individuals with the disabilities related to HIV. Not only can South African physiotherapists play a significant role in improving the lives of PLHIV, but by responding proactively to the HIV epidemic they can reinforce the relevance and value of the profession in this country at a time when many newly qualified therapists are unable to secure employment. This paper offers recommendations that may help to fuel this response. These ideas include enhancing HIV curricula at a tertiary level, designing and attending continuing education courses on HIV and researching Southern African rehabilitation interventions for HIV at all levels of practice. furthermore, it is vital that physiotherapists are at the forefront of directing multi-disciplinary responses to the rehabilitation of PLHIV in order to influence stakeholders who are responsible for health policy formulation. it is hoped that this paper stimulates discussion and further ideas amongst physiotherapists and other health professionals in order to improve the quality and access to care available to PLHIV in South Africa.

scholarly journals Evaluation of a Novel Point-of-Care Cryptococcal Antigen Test on Serum, Plasma, and Urine From Patients With HIV-Associated Cryptococcal Meningitis

2011 ◽  
Vol 53 (10) ◽  
pp. 1019-1023 ◽  
Author(s):  
J. N. Jarvis ◽  
A. Percival ◽  
S. Bauman ◽  
J. Pelfrey ◽  
G. Meintjes ◽  
...  
Keyword(s):  
Cryptococcal Meningitis ◽  
Point Of Care ◽  
Antigen Test ◽  
Cryptococcal Antigen

scholarly journals Cryptococcal antigen carriage among HIV infected children aged 6 months to 15 years at Laquintinie Hospital in Douala

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253781
Author(s):  
Ginette Claude Mireille Kalla ◽  
Josette Farida Mboumnyemb ◽  
Jules Clément Nguedia Assob ◽  
Marcelle Nina Ehouzou Mandeng ◽  
Nelly Kamgaing Noubi ◽  
...  
Keyword(s):  
Strong Association ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
World Health ◽  
Treatment Center ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Cryptococcal Antigen ◽  
Severe Immunosuppression ◽  
Living With Hiv

Background Up to 15% of deaths of people living with HIV is attributable to meningeal cryptococcosis, with nearly 75% occuring in sub-Saharan Africa. Although rare in children, it is a major cause of morbidity and mortality in people living with HIV. A strong association between cryptococcal antigenemia and the development of meningeal cryptococcosis has been shown in adults. Thus, in 2018, the World Health Organization published an updated version of its guidelines for the diagnosis, prevention and management of cryptococcal infection in adults, adolescents and the HIV-infected child. Goal To determine the prevalence of cryptococcal antigenemia and to identify its determinants in children infected with HIV. Methods An analytical cross-sectional study was carried out at the approved treatment center of Laquintinie hospital in Douala over a period of 4 months. Children were recruited consecutively after informed parental consent. Cryptococcal antigenemia and CD4 assay were performed using a Cryptops® immunochromatographic rapid diagnostic test and flow cytometry, respectively. The data collected included the socio-demographic, clinical and paraclinical variables of the children, as well as their antecedents. Data analysis was performed using Epiinfo software version 3.1 and SPSS 21.0. The significance threshold was set at 5%. Results A total of 147 children were enrolled. The mean age was 9.8 ± 4.09 years. The majority were on antiretroviral therapy (142, 96.60%). Only 13 (8.80%) were in severe immunosuppression. No child showed signs of meningeal cryptococcosis. The prevalence of cryptococcal antigenemia was 6.12%. Severe immunosuppression [OR: 10.03 (1.52–65.91), p = 0.016] and contact with pigeons [OR: 9.76 (1.14–83.65), p = 0.037] were independent factors significantly associated with the carriage of the cryptococcal antigen. Conclusion We recommend screening for cryptococcal antigenemia and routine treatment with fluconazole of all HIV positive children with cryptococcal antigen whether symptomatic or not.

Sign in / Sign up

Export Citation Format

Share Document