Prevalence of cryptococcal infection among advanced HIV patients in Argentina using lateral flow immunoassay
Publication Date
June 15, 2017
Authors
Claudia Frola, Liliana Guelfand, Gabriela Blugerman, Edgardo Szyld, et al
Volume
12
Issue
6
Pages
e0178721
DOI
https://dx.plos.org/10.1371/journal.pone.0178721
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0178721
Scopus
85021157205
Mendeley
http://www.mendeley.com/research/prevalence-cryptococcal-infection-among-advanced-hiv-patients-argentina-using-lateral-flow-immunoass
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Mendeley | Further Information

{"title"=>"Prevalence of cryptococcal infection among advanced HIV patients in Argentina using lateral flow immunoassay", "type"=>"journal", "authors"=>[{"first_name"=>"Claudia", "last_name"=>"Frola", "scopus_author_id"=>"57194597339"}, {"first_name"=>"Liliana", "last_name"=>"Guelfand", "scopus_author_id"=>"6602435436"}, {"first_name"=>"Gabriela", "last_name"=>"Blugerman", "scopus_author_id"=>"57193457343"}, {"first_name"=>"Edgardo", "last_name"=>"Szyld", "scopus_author_id"=>"6505966077"}, {"first_name"=>"Sara", "last_name"=>"Kaufman", "scopus_author_id"=>"7401601880"}, {"first_name"=>"Pedro", "last_name"=>"Cahn", "scopus_author_id"=>"7005552107"}, {"first_name"=>"Omar", "last_name"=>"Sued", "scopus_author_id"=>"35228139200"}, {"first_name"=>"Héctor", "last_name"=>"Pérez", "scopus_author_id"=>"7102956207"}], "year"=>2017, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"616860927", "pmid"=>"28617817", "doi"=>"10.1371/journal.pone.0178721", "issn"=>"19326203", "scopus"=>"2-s2.0-85021157205", "sgr"=>"85021157205", "isbn"=>"1111111111"}, "id"=>"880799f7-4db7-38fb-a87d-15b58b8fc172", "abstract"=>"BACKGROUND Globally, Latin America ranks third among regions with most cases of AIDS related cryptococcal meningitis. In 2009, a lateral flow immunoassay (LFA) for the detection of cryptococcal antigen (CrAg) was developed as a potential point-of-care test for diagnosis of cryptococcal infection. In 2011 World Health Organizations recommended on CrAg screening for HIV positive persons with CD4 below 100 cells/μL, followed by preemptive fluconazole treatment. However, in Argentina no formal recommendations for CrAg screening have been issued. METHODS HIV positive patients > = 18 years with advanced immunosuppression (CD4 counts ≤100 cells/μL within 3 months or WHO stage III/IV), who visited the hospital between April 1, 2014 and January 31, 2015, were included. The LFA was performed according to the manufacturer's instructions on all serum samples. When CrAg detection was positive, a lumbar puncture was performed to rule out cryptococcal meningitis. Patients without evidence of meningeal involvement were treated with preemptive oral fluconazole in ambulatory care. RESULTS We included 123 patients. Prevalence of CrAg-positivity was 8.1%. Among the 10 CrAg-positive patients, 6 had meningeal involvement detected through the CSF analysis (CSF India-ink testing, CSF CrAg and culture). The remaining 4 patients with positive CrAg received targeted preemptive treatment with oral fluconazole and were free of cryptococcal disease during the follow-up period. None of the 113 patients with a negative CrAg test result developed cryptococcal disease. CONCLUSIONS This is the first study in Argentina, to our knowledge, describing the prevalence of cryptococcosis and usefulness of CrAg screening. LFA provided early diagnosis to determine a high prevalence of CrAg in our hospital, and that screening for subclinical infection with preemptive antifungal treatment, prevented a substantial proportion of meningeal disease.", "link"=>"http://www.mendeley.com/research/prevalence-cryptococcal-infection-among-advanced-hiv-patients-argentina-using-lateral-flow-immunoass", "reader_count"=>10, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Student > Doctoral Student"=>1, "Researcher"=>1, "Other"=>2, "Student > Master"=>2, "Lecturer"=>1, "Student > Postgraduate"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Student > Doctoral Student"=>1, "Researcher"=>1, "Other"=>2, "Student > Master"=>2, "Lecturer"=>1, "Student > Postgraduate"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>3, "Agricultural and Biological Sciences"=>1, "Immunology and Microbiology"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>3}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Unspecified"=>{"Unspecified"=>3}}, "group_count"=>1}

Scopus | Further Information

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