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

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Cryptococcal meningitis Medicine Human immunodeficiency virus (HIV) Internal medicine Immunology Viral disease

Ditte Boeg Thomsen , Cecilie Juul Hviid , Bo Langhoff Hønge , Cándida Medina , David Te , Faustino Gomes Correira , Lars Østergaard , Christian Erikstrup , Christian Wejse , Alex Lund Laursen , Sanne Jespersen ·

YOU? · · 2018 · Open Access · · DOI: https://doi.org/10.11604/pamj.2018.29.18.14099 · OA: W2782749789

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.