» Articles » PMID: 39728839

High Cryptococcal Antigenuria Prevalence in a Population of PLHIV with Neurological Symptoms Hospitalized in the Infectious Diseases Wards of the Centre Hospitalier Universitaire De Libreville, Gabon

Abstract

Cryptococcal meningitis is a major cause of death in HIV/AIDS patients due to the existence of in the central nervous system. Our objective was to evaluate the prevalence of Cryptococcus antigenuria in a population of HIV-infected patients in Libreville, Gabon. : This study was conducted from April to October 2021 at the Infectious Diseases ward of the Centre Hospitalier Universitaire de Libreville. Hospitalized patients with HIV were included. The detection of cryptococcal antigen (CrAg) in urine was performed using the Pastorex Crypto Plus Kit. : Out of the 255 PLHIV, 142 benefited from the CrAg detection. The prevalence of urine CrAg was 24.6% (n = 35). The majority of CrAg+ patients (82.8%; n = 29) were under 55 years old. Almost three-quarters of them (n = 25; 71.4%) had CD4 counts < 200, and 80.0% (n = 28) were at WHO clinical stages III and IV. All patients with neck stiffness at admission had a CrAg positive test. : This study showed a non-negligible prevalence of Cryptococcal urinary antigen in HIV-infected patients with neurological symptoms. These data underline the importance of CrAg screening in routine care for better management of PLHIV.

References
1.
Drain P, Galagan S, Govere S, Krows M, Thulare H, Wallis C . Laboratory Reflex and Clinic-Based Point-of-Care Cryptococcal Antigen Screening for Preventing Meningitis and Mortality Among People Living With HIV. J Acquir Immune Defic Syndr. 2021; 87(5):1205-1213. PMC: 8263484. DOI: 10.1097/QAI.0000000000002717. View

2.
Govender N, Meintjes G, Mangena P, Nel J, Potgieter S, Reddy D . Southern African HIV Clinicians Society guideline for the prevention, diagnosis and management of cryptococcal disease among HIV-infected persons: 2019 update. South Afr J HIV Med. 2020; 20(1):1030. PMC: 7081625. DOI: 10.4102/sajhivmed.v20i1.1030. View

3.
Temfack E, Kouanfack C, Mossiang L, Loyse A, Fonkoua M, Molloy S . Cryptococcal Antigen Screening in Asymptomatic HIV-Infected Antiretroviral Naïve Patients in Cameroon and Evaluation of the New Semi-Quantitative Biosynex CryptoPS Test. Front Microbiol. 2018; 9:409. PMC: 5859387. DOI: 10.3389/fmicb.2018.00409. View

4.
Aguilar G, Lopez G, Sued O, Medina N, Caceres D, Pereira J . Implementation of a rapid diagnostic assay package for cryptococcosis, histoplasmosis and tuberculosis in people living with HIV in Paraguay. BMC Infect Dis. 2024; 24(1):406. PMC: 11020460. DOI: 10.1186/s12879-024-09257-5. View

5.
Lee Y, Wang J, Sun H, Chen Y . Comparisons of clinical features and mortality of cryptococcal meningitis between patients with and without human immunodeficiency virus infection. J Microbiol Immunol Infect. 2011; 44(5):338-45. DOI: 10.1016/j.jmii.2010.08.011. View