CRYPTOCOCCAL ANTIGENEMIA IN HIV/AIDS PATIENTS USING LATERAL FLOW IMMUNOASSAY DETECTION AT Dr. SOETOMO GENERAL HOSPITAL SURABAYA

Sajuni Widjaja, Erwin Astha Triyono, Arthur Pohan Kawilarang, Abu Rohiman

= http://dx.doi.org/10.20473/ijtid.v7i1.6311
Abstract views = 356 times | views = 339 times

Abstract


Cryptococcus  infection in HIV / AIDS patients results in cryptococcal meningitis, a major cause of subacute meningitis  with 100% mortality if not receiving appropriate antifungal therapy. An examination of cryptococcal antigen will provide risk information for patients who will experience cryptococcal meningitis. Better diagnosis in asymptomatic and symptomatic phases of cryptococcosis are key components to reduce morbidity and mortality. This study aims to determine the proportion of cryptococcal antigenemia in HIV / AIDS patients treated at Intermediate Treatment-Infectious Diseases Unit of Dr. Soetomo General Hospital Surabaya. Cryptococcal antigenemia was examined in HIV / AIDS patients with suspected Cryptococcus infection and CD4+ T cell lymphocyte count <200 cell /μl. The examination used a lateral flow assay diagnostic tool, a simple FDA(Food and Drug Administration)-approved immunochromatographic test system for detection of capsular polysccharide antigens of Cryptococcus species complex (Cryptococcus neoformans and Cryptococcus gattii) in blood. This test meets all of the World Health Organization ASSURED criteria (affordable, sensitive, specific, user friendly, rapid/robust, equipment-free, and delivered). Sensitivity and specifiticy of this method from serum are both 100%. There were 3 positive cryptococcal antigenemia from 41 serum HIV / AIDS patients with suspected cryptococcus infection at Intermediate Treatment- Infectious Diseases Unit of Dr. Soetomo General Hospital Surabaya. All of these patients were male aged over 36 years, had CD4+ T cell lymphocytes <100 cell /μl and had never received antiretroviral therapy before. The proportion of cryptococcal antigenemia in HIV / AIDS patients with suspected Cryptococcus infection at Intermediate Treatment-Infectious Diseases Unit of Dr. Soetomo General Hospital Surabaya was 7.32%.

Keywords


Cryptococcal antigenemia; AIDS; HIV; Dr. Soetomo Hospital; Surabaya

Full Text:

PDF

References


Denning DW. Minimizing fungal disease deaths will allow the UNAIDS target of reducing annual AIDS deaths below 500 000 by 2020 to be realized. Philos Trans R Soc B Biol Sci. 2016;371(1709):20150468.

Park BJ, Wannemuehler KA, Marston BJ, Govender N, Pappas PG, Chiller TM. Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS. AIDS. 2009 Feb 20;23(4):525–30.

Jarvis JN, Meintjes G, Williams A, Brown Y, Crede T, Harrison TS. Adult meningitis in a setting of high HIV and TB prevalence: findings from 4961 suspected cases. BMC Infect Dis. 2010 Dec 15;10(1):67.

Rajasingham R, Smith RM, Park BJ, Jarvis JN, Govender NP, Chiller TM, et al. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. Lancet Infect Dis. 2017 Aug;17(8):873–81.

Alemu AS, Kempker RR, Tenna A, Smitson C, Berhe N, Fekade D, et al. High Prevalence of Cryptococcal Antigenemia among HIV-infected Patients Receiving Antiretroviral Therapy in Ethiopia. PLoS One. 2013;8(3).

Vidal JE, Toniolo C, Paulino A, Colombo A, Dos Anjos Martins M, da Silva Meira C, et al. Asymptomatic cryptococcal antigen prevalence detected by lateral flow assay in hospitalised HIV-infected patients in São Paulo, Brazil. Trop Med Int Health. 2016;21(12):1539–44.

Use I. Cryptococcal Antigen Lateral Flow Assay Performance Summary. Culture. (Figure 1).

Vidal JE, Boulware DR. LATERAL FLOW ASSAY FOR CRYPTOCOCCAL ANTIGEN: AN IMPORTANT ADVANCE TO IMPROVE THE CONTINUUM OF HIV CARE AND REDUCE CRYPTOCOCCAL MENINGITIS-RELATED MORTALITY. Rev Inst Med Trop Sao Paulo. 2015 Sep;57 Suppl 1:38–45.

Meya DB, Manabe YC, Castelnuovo B, Cook BA, Elbireer AM, Kambugu A, et al. Cost-effectiveness of serum cryptococcal antigen screening to prevent deaths among HIV-infected persons with a CD4+ cell count < or = 100 cells/microL who start HIV therapy in resource-limited settings. Clin Infect Dis. 2010 Aug 15;51(4):448–55.

Parkes-Ratanshi R, Wakeham K, Levin J, Namusoke D, Whitworth J, Coutinho A, et al. Primary prophylaxis of cryptococcal disease with fluconazole in HIV-positive Ugandan adults: a double-blind, randomised, placebo-controlled trial. Lancet Infect Dis. 2011 Dec;11(12):933–41.

Rajasingham R, Meya DB, Boulware DR. Integrating Cryptococcal Antigen Screening and Pre-Emptive Treatment into Routine HIV Care. JAIDS J Acquir Immune Defic Syndr. 2012 Apr;59(5):85–91.

Manga NM, Cisse-diallo VMP, Dia-badiane NM, Diop-nyafouna SA, Er D, Yengo N, et al. Prevalence and Factors Associated with Positive Cryptococcal Antigenemia among HIV Infected Adult Hospitalized in Senegal Epidemiological aspects. 2016;1–6.

Ganiem AR, Indrati AR, Wisaksana R, Meijerink H, Van Der Ven A, Alisjahbana B, et al. Asymptomatic cryptococcal antigenemia is associated with mortality among HIV-positive patients in Indonesia. J Int AIDS Soc. 2014;17:1–7.

Kauffman CA. Fungal infections in older adults. Clin Infect Dis. 2001;33(4):550–5.

Gangcuangco LMA, Sawada I, Tsuchiya N, Do CD, Pham TTT, Rojanawiwat A, et al. Regional Differences in the Prevalence of Major Opportunistic Infections among Antiretroviral-Naïve Human Immunodeficiency Virus Patients in Japan, Northern Thailand, Northern Vietnam, and the Philippines. Am J Trop Med Hyg. 2017 Jul;97(1):49–56.

Andama AO, den Boon S, Meya D, Cattamanchi A, Worodria W, Davis JL, et al. Prevalence and Outcomes of Cryptococcal Antigenemia in HIV-Seropositive Patients Hospitalized for Suspected Tuberculosis in Uganda. JAIDS J Acquir Immune Defic Syndr. 2013 Jun;63(2):189–94.

Jarvis JN, Harrison TS. HIV-associated cryptococcal meningitis. AIDS. 2007 Oct;21(16):2119–29.

World Health Organization. Global Tuberculosis Report. 2016.

Rajian M, Gill PS, Chaudhary U. Effect of Tuberculosis Co infection on Virological Failure in HIV Patients on First Line of Highly Active Antiretroviral Therapy. IntJCurrMicrobiolAppSci. 2017;6(1):78–81.

Davoudi S, Rasoolinegad M, Younesian M, Hajiabdolbaghi M, Soudbakhsh A, Jafari S, et al. CD4+ cell counts in patients with different clinical manifestations of tuberculosis. Brazilian J Infect Dis. 2008 Dec;12(6):483–6.

Pawlowski A, Jansson M, Sköld M, Rottenberg ME, Källenius G. Tuberculosis and HIV Co-Infection. Hobman TC, editor. PLoS Pathog. 2012 Feb 16;8(2):e1002464.


Refbacks

  • There are currently no refbacks.




Copyright (c) 2018 Indonesian Journal of Tropical and Infectious Disease

View My Stats

IJTID Indexed by : 

                                                    

 


IJTID (pISSN 2085-1103eISSN 2356-0991is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Institute of Tropical Disease - Airlangga University
Gedung Lembaga Penyakit Tropis Lt.1, Kampus C Universitas Airlangga
Jln. Mulyorejo Surabaya 60115, Indonesia
E-mail: ijtid@itd.unair.ac.id