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Prevalence of Cryptococcal Antigen and Outcomes in People With Human Immunodeficiency Virus in Honduras: A Cohort Study.

Abstract：

Background:Cryptococcal meningitis is a major cause of death among people with human immunodeficiency virus (PWH). Cryptococcal antigen (CrAg) testing of asymptomatic patients is an important public health measure to reduce mortality in high-incidence areas. However, limited data exist on CrAg prevalence in Central America. Methods:We conducted a prospective cohort study at the 2 largest human immunodeficiency virus (HIV) clinics and hospitals in Honduras. Cryptococcal antigen in serum and cerebrospinal fluid was performed in individuals with HIV who had CD4 ≤100 cells/mm3 between 2017 and 2018. After CrAg testing, individuals were observed for 12 months to assess mortality using adjusted Cox proportional hazard models. Results:A total of 220 PWH were tested for CrAg, 12.7% (n = 28) of which tested positive. Cryptococcal antigen prevalence was higher among hospitalized individuals in 40% (n = 10 of 25) of the cases. The proportion (35.8%) of individuals taking antiretroviral therapy was significantly (P < .01) lower among those who tested positive for CrAg. Overall mortality among the cohort was 11.4% (n = 25 of 220) by 12 months. Cryptococcal antigen-positive cases were at a significantly higher risk of death (adjusted hazard ratio, 2.69; 95% confidence interval, 1.07-6.84) compared with CrAg-negative participants. Conclusions:Cryptococcal antigen prevalence in Honduras was high among PWH. Moreover, individuals who tested positive for CrAg testing were at a higher risk of death. Systemic CrAg of PWH with a CD4 ≤100 cells/mm3 should be routinely performed in Central America.

journal_name

Open Forum Infect Dis

journal_title

Open forum infectious diseases

authors

Zuniga-Moya JC,Romero-Reyes LE,Saavedra EB,Montoya S,Varela D,Borjas M,Cerna A,Bejarano S,Martinez P,Lujan K,Erazo K,Lainez I,Pineda L,Yanes D,O'Halloran JA,Spec A

doi

10.1093/ofid/ofaa557

subject

Has Abstract

pub_date

2020-11-13 00:00:00

pages

ofaa557

issue

1

issn

2328-8957

pii

ofaa557

journal_volume

8

pub_type

杂志文章

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