A Ogouyèmi-Hounto1, D M Zannou2, G Ayihounton3, C Ahouada3, A Azon-Kouanou2, J Acakpo3, Y Sissinto Savi de Tove4, D Kinde Gazard4. 1. Laboratoire de parasitologie-mycologie, centre national hospitalier universitaire Koutoukou Maga (CNHU/HKM), 03BP386, Cotonou, Benin. Electronic address: aurorefel@yahoo.fr. 2. Service de médecine interne, centre national hospitalier universitaire Koutoukou Maga (CNHU/HKM), 03BP386, Cotonou, Benin; Centre de traitement ambulatoire (CTA), Cotonou, Benin. 3. Centre de traitement ambulatoire (CTA), Cotonou, Benin. 4. Laboratoire de parasitologie-mycologie, centre national hospitalier universitaire Koutoukou Maga (CNHU/HKM), 03BP386, Cotonou, Benin.
Abstract
OBJECTIVE: Determine the prevalence of cryptococcal antigenemia and associated factors in HIV-infected patients in Cotonou in order to introduce systematic screening in national guidelines. PATIENTS AND METHODS: This is a cross-sectional, descriptive and analytical study conducted from June to September 2015 in four outpatient treatment centers with adult patients infected with HIV, receiving or not antiretroviral treatment with a number of CD4≤200cell/μL and who have given their informed consent to participate in the study. For each enrolled patient, after signing the informed consent form, it was made a clinical examination and administration of a questionnaire to collect general information, treatment and biological data. Then a blood sample for counting CD4 lymphocytes and the search of cryptococcal antigenemia were done. RESULTS: In total, 355 patients were included in the study with a mean age of 40±10.2years. The overall prevalence of cryptococcal antigenemia is 1.7%. All patient with cryptococcal antigenemia have a CD4 count below 100cells/μL with a majority having CD4 count below 50cells/μL. Body mass index<18.5kg/m2, an alteration of the general condition with a CD4 lymphocyte counts<50cells/μL are the main factors associated with the occurrence of cryptococcal antigenemia. CONCLUSION: This pilot study showed a low prevalence of cryptococcal antigenemia in the study population, but higher in highly immuno-deficient patients with CD4 counts<50cells/μl. Given the results obtained, the introduction of routine screening among patients infected with HIV could be reserved to those with CD4 counts<50cells/μl. Copyright Â
OBJECTIVE: Determine the prevalence of cryptococcal antigenemia and associated factors in HIV-infectedpatients in Cotonou in order to introduce systematic screening in national guidelines. PATIENTS AND METHODS: This is a cross-sectional, descriptive and analytical study conducted from June to September 2015 in four outpatient treatment centers with adult patients infected with HIV, receiving or not antiretroviral treatment with a number of CD4≤200cell/μL and who have given their informed consent to participate in the study. For each enrolled patient, after signing the informed consent form, it was made a clinical examination and administration of a questionnaire to collect general information, treatment and biological data. Then a blood sample for counting CD4 lymphocytes and the search of cryptococcal antigenemia were done. RESULTS: In total, 355 patients were included in the study with a mean age of 40±10.2years. The overall prevalence of cryptococcal antigenemia is 1.7%. All patient with cryptococcal antigenemia have a CD4 count below 100cells/μL with a majority having CD4 count below 50cells/μL. Body mass index<18.5kg/m2, an alteration of the general condition with a CD4 lymphocyte counts<50cells/μL are the main factors associated with the occurrence of cryptococcal antigenemia. CONCLUSION: This pilot study showed a low prevalence of cryptococcal antigenemia in the study population, but higher in highly immuno-deficientpatients with CD4 counts<50cells/μl. Given the results obtained, the introduction of routine screening among patients infected with HIV could be reserved to those with CD4 counts<50cells/μl. Copyright Â
Authors: Nathan Ford; Zara Shubber; Joseph N Jarvis; Tom Chiller; Greg Greene; Chantal Migone; Marco Vitoria; Meg Doherty; Graeme Meintjes Journal: Clin Infect Dis Date: 2018-03-04 Impact factor: 9.079