Abstract
A total of 817 human immunodeficiency virus-infected Ethiopians with CD4 <150 cells/mL underwent plasma cryptococcal antigen (CRAG) screening. CRAG prevalence was 6.2%. Of participants with plasma CRAG titers >1:640, 96% (27 of 28) had cryptococcal meningitis (cerebrospinal fluid CRAG-positive) whereas 50% (7 of 14) with 1:160-1:320 titers had meningitis. With fluconazole 1200 mg/d therapy, 68% of meningitis patients (23 of 34) died within 3 months. Plasma CRAG titers >1:160 predict meningitis, requiring more intensive antifungal therapy.
Keywords:
Cryptococcal meningitis /PC; Cryptococcosis /PC; Cryptococcus; Ethiopia; Fluconazole; Mass Screening; Prevention & Control.
© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
MeSH terms
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AIDS-Related Opportunistic Infections / complications
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AIDS-Related Opportunistic Infections / epidemiology
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AIDS-Related Opportunistic Infections / virology
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Adult
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Antifungal Agents / administration & dosage
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Antifungal Agents / adverse effects*
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Antifungal Agents / therapeutic use
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Antigens, Fungal / cerebrospinal fluid
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Antigens, Fungal / drug effects*
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Cryptococcus / drug effects
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Ethiopia / epidemiology
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Female
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Fluconazole / administration & dosage
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Fluconazole / adverse effects*
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Fluconazole / therapeutic use
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HIV Infections / complications*
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HIV Infections / epidemiology
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HIV Infections / virology
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HIV Seropositivity
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Humans
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Male
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Mass Screening
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Meningitis, Cryptococcal / blood
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Meningitis, Cryptococcal / drug therapy*
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Meningitis, Cryptococcal / epidemiology
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Meningitis, Cryptococcal / prevention & control
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Mortality
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Prevalence
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Prospective Studies
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Young Adult
Substances
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Antifungal Agents
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Antigens, Fungal
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Fluconazole