Indian Journal of Medical Microbiology IAMM  | About us |  Subscription |  e-Alerts  | Feedback |  Login   
  Print this page Email this page   Small font sizeDefault font sizeIncrease font size
 Home | Ahead of Print | Current Issue | Archives | Search | Instructions  
Users Online: 1053 Official Publication of Indian Association of Medical Microbiologists 
 ~   Next article
 ~   Previous article
 ~   Table of Contents

 ~   Similar in PUBMED
 ~  Search Pubmed for
 ~  Search in Google Scholar for
 ~Related articles
 ~   Citation Manager
 ~   Access Statistics
 ~   Reader Comments
 ~   Email Alert *
 ~   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed110    
    Printed1    
    Emailed0    
    PDF Downloaded15    
    Comments [Add]    

Recommend this journal

 

 ORIGINAL ARTICLE
Year : 2017  |  Volume : 35  |  Issue : 1  |  Page : 105-108

High prevalence of cryptococcal antigenaemia amongst asymptomatic advanced HIV patients in Pune, India


1 Department of Medicine, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India
2 Department of Orthopedics, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India
3 Department of Microbiology, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India
4 Clinical Research Site, Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University, Pune, Maharashtra, India
5 Department of Otolaryngology, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India
6 Clinical Research Site, Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University, Pune, Maharashtra, India; Division of Infectious Diseases, Johns Hopkins University, Baltimore, USA
7 Division of Infectious Diseases, Johns Hopkins University, Baltimore, USA

Correspondence Address:
Renu Bharadwaj
Department of Microbiology, 1st Floor, Byramjee Jeejeebhoy Medical College, Jai Prakash Narayan Road, Pune - 411 001, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmm.IJMM_15_596

Rights and Permissions

Background: The World Health Organization recommends routine cryptococcal antigen (CrAg) screening in advanced AIDS patients initiating antiretroviral treatment (ART). India has yet to adopt this strategy as the burden of cryptococcal antigenaemia is unknown. Methods: A prospective study was conducted in a large public sector ART centre and the inpatient wards of Sassoon Hospital, Pune, India. All consenting patients >18 years of age with CD4 count <100 cells/mm3 were screened for CrAg by latex agglutination assay. Those with positive CrAg underwent cerebrospinal fluid analysis, chest radiograph and abdominal ultrasound to rule out cryptococcal disease. The impact of CrAg positivity on all-cause mortality was assessed by logistic regression analysis. Results: Amongst 208 AIDS patients with CD4 cells <100 cells/mm3 who underwent CrAg testing, median age was 40 (interquartile range [IQR], 35–49) years, 134 (64%) were male and median CD4 count was 64.5 cells/mm3 (IQR, 37–82). Overall, 16 (8%, 95% confidence interval [CI], 4–12) patients were positive for CrAg, of which 8 (50%) had CD4 cells <50 cells/mm3 and 3 (19%) CrAg-positive patients had incidental cryptococcal meningitis. At 6-month follow-up, the case fatality rate was higher amongst CrAg-positive patients (38%) compared with CrAg-negative patients (18%) (P = 0.06). After adjusting for age, sex, CD4 count and ART, there was a trend towards increased all-cause mortality (adjusted OR, 3.18, 95% CI, 0.60–16.88,P= 0.17). Conclusions: We found an 8% prevalence of cryptococcaemia amongst adult AIDS patients with CD4 cells <100 cells/mm3. Given the high fatality rates observed, routine screening for CrAg should be considered for all Indian persons with advanced HIV disease.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

Online since April 2001, new site since 1st August '04