CRYPTOCOCCAL ANTIGENAEMIA IN ANTIRETROVIRAL THERAPY NAIVE PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS INFECTION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 90
Abstract
BACKGROUND Human 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 METHODS This 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. RESULTS Out 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 m2 (range15.1-26.48) and CD4 count 196 (range 6 -780) cells/mm3. 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/mm3. 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). CONCLUSION All ART naive adults having CD4 count < 100 cells/mm3 should be screened for serum Cryptococcal antigen followed by presumptive antifungal therapy if serum Cryptococcal antigen is positive.
Authors and Affiliations
Dibya Prasana Mohanty, Dharma Niranjan Mishra, Dillip Kumar Pradhan
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