Aim: To assess the prevalence of cryptococcal antigenemia among people living with HIV/AIDS (PLHA) with CD4 ≤100/mm.
Design: This observational study was performed on PLHA with laboratory-confirmed CD4 ≤100/mm. All PLHA were recruited irrespective of their duration of HIV diagnosis, antiretroviral therapy (ART) naïve, or ART failure.
Methods: The prevalence of cryptococcal antigen (CrAg) was assessed in 102 PLHA, with CD4 ≤100/mm, using a latex agglutination test on serum samples. All the subjects were followed up for 3 months.
Results: Amongst 102 PLHA, 62 (60.8%) and 40 (39.2%) patients were ART-naïve and ART failures, respectively, with 2.9% ( = 3) having clinical features of meningitis and 6.8% ( = 7) patients being asymptomatic CrAg-positive. At the 3 month follow-up, total mortality was 10.8%, of which 33.3% and 8.8% were among CrAg-positive and negative patients ( = 0.05). Mortality in asymptomatic and meningitis symptomatic CrAg-positive patients was 1.03% ( = 1) and 2.06% ( = 2), respectively. Of note, five patients were lost to follow-up.
Conclusion: Cryptococcal antigenemia is common among patients with CD4 ≤100/mm who were either ART naïve or had treatment failure. Asymptomatic patients who underwent pre-emptive therapy demonstrated good clinical outcomes.
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