Cryptococcal Antigenaemia in Antiretroviral Therapy Naive Patients With Human Immunodeficiency Virus Infection

Abstract

BACKGROUNDHuman Immunodeficiency Virus (HIV) related to cryptococcal meningitis in India is a leading cause of morbidity and mortality among severely immunocompromised patients.The aim of our study was to determine the prevalence of and risk factors for Cryptococcal antigenaemia among HIV-infected adults attending ART clinic and medical emergency. MATERIALS AND METHODSThis was a hospital-based cross-sectional and prospective study carried out among newly diagnosed and confirmed HIV-infected patients after taking written informed consent and due ethical approval. Results were presented in simple tables with distribution and percentages while P value ≤ 0.05 was considered as statistically significant. RESULTSOut of 100 patients, there were 65 (65%) males and 35 (35%) females in the study. The median age was being 35 years (range18-67) followed by BMI 20.271 m 2 (range15.1-26.48) and CD4 count 196 (range 6 -780) cells/mm 3 . Out of 100 patients, seven (7%) were positive for cryptococcal antigen (CRAG). Six (85.71%) of them were CRAG positives with CD4+ cell count less than 100 cells, while 1 (14.28%) had count above 100 cells/mm 3 . There were 4 (23.5%) SCRAG+ out of 17 symptomatic cases and 3 (3.6%) were SCRAG+ out of 83 asymptomatic patients with statistical significance (p<0.015). The symptoms of fever, headache, vomiting and neck rigidity are significantly associated with Cryptococcal antigenaemia (p<0.05). CONCLUSIONAll ART naive adults having CD4 count < 100 cells/mm 3 should be screened for serum Cryptococcal antigen followed by presumptive antifungal therapy if serum Cryptococcal antigen is positive.