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. 2018 Jan 9:29:18.
doi: 10.11604/pamj.2018.29.18.14099. eCollection 2018.

Increased mortality among HIV infected patients with cryptococcal antigenemia in Guinea-Bissau

Ditte Thomsen  1   2 , Cecilie Juul Hviid  3 , Bo Langhoff Hønge  1   2   3 , Candida Medina  4 , David Da Silva Té  4 , Faustino Gomes Correira  4 , Lars Østergaard  3 , Christian Erikstrup  2 , Christian Wejse  3   5 , Alex Lund Laursen  3 , Sanne Jespersen  1   3
Affiliations

Increased mortality among HIV infected patients with cryptococcal antigenemia in Guinea-Bissau

Ditte Thomsen et al. Pan Afr Med J. .

Abstract

Cryptococcal antigenemia may precede development of cryptococcal meningitis and death among patients with advanced HIV infection. Among 200 retrospectively and randomly selected ART-naïve patients with CD4 counts < 100 cells/μl from Guinea-Bissau, 20 (10%) had a positive cryptococcal antigen test. Self-reported headache and fever were predictors of a positive test, while cryptococcal antigenemia was a strong predictor of death within the first year of follow-up, MRR 2.22 (95% CI: 1.15-4.30). Screening for cryptococcal antigenemia should be implemented for patients with advanced HIV in Guinea-Bissau. Pre-emptive anti-fungal therapy should be initiated prior to ART-initiation if the screening is positive.

Keywords: Cryptococcal antigenemia; Guinea-Bissau; HIV; antigen screening; cryptococcal meningitis; lateral flow assay.

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Figures

Figure 1
Figure 1
Survival estimates according to cryptococcal antigen status within 1-year of follow-up
See this image and copyright information in PMC

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