Preventing Cryptococcosis—Shifting the Paradigm in the Era of Highly Active Antiretroviral Therapy

Meya, David; Rajasingham, Radha; Nalintya, Elizabeth; Tenforde, Mark; Jarvis, Joseph N

doi:10.1007/s40475-015-0045-z

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Preventing Cryptococcosis—Shifting the Paradigm in the Era of Highly Active Antiretroviral Therapy

Published Date:

2015

Publisher's site:

http://dx.doi.org/10.1007/s40475-015-0045-z New Site Icon

Source:

Curr Trop Med Rep. 2(2):81-89.

[PDF-261.55 KB]

Details:

Personal Authors:

Meya, David ; Rajasingham, Radha ; Nalintya, Elizabeth ; Tenforde, Mark ; Jarvis, Joseph N ;

Keywords:

[+]

Pubmed ID:

25960942

Pubmed Central ID:

PMC4412515

Description:

Cryptococcosis remains a significant cause of morbidity and mortality among HIV-infected patients, especially in sub-Saharan Africa where it causes up to 20 % of AIDS-related deaths in HIV programs. A new, highly sensitive, and affordable point of care diagnostic test for cryptococcal infection, the lateral flow assay, can detect early sub-clinical cryptococcosis especially in areas with limited laboratory infrastructure. With a prevalence of detectable sub-clinical cryptococcal infection averaging 7.2 % (95 % CI 6.8-7.6 %) among 36 cohorts with CD4 <100 cells/μL in Africa, together with data showing that preemptive fluconazole prevents overt cryptococcal disease in this population, implementing a screen and treat strategy as part of HIV care practice among patients with CD4 <100 cells/μL could prevent the incidence of often fatal cryptococcal meningitis in the setting of the HIV pandemic.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

U01 AI089244/AI/NIAID NIH HHS/United States
U01 GH000517/GH/CGH CDC HHS/United States
P30 AI045008/AI/NIAID NIH HHS/United States
R01 AI078934/AI/NIAID NIH HHS/United States
R01 AI108479/AI/NIAID NIH HHS/United States
087540/Wellcome Trust/United Kingdom

Supporting Files:

40475_2015_Article_45.nxml

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