Revista de SIDA e investigación clínica

Low Prevalence of Cryptococcal Antigenemia among Patients Infected with HIV/AIDS in Haiti

Abstract

Frantz Jean Louis, Jocelyne Alboth Andre, Georges Perrin, Jean Wysler Domercant, Kesner Francois, Daniella Azor, Josiane Buteau, Jacques Boncy, Robert Burris, David W Lowrance and Barbara J Marston

Cryptococcal meningitis is a common opportunistic infection among persons with advanced HIV-associated immunosuppression and is associated with high mortality. The prevalence of asymptomatic cryptococcal antigenemia (CrAg) can inform the potential utility of screening and pre-emptive treatment prevention strategies. We assessed CrAg prevalence in a cohort of patients infected with HIV at 28 health facilities from February to September 2014 in order to inform Haitian national clinical guidelines. Of 13,000 patients that underwent CD4 cell count, 1,025 (7.9%) had a count ≤200 cells/mm3. Of these, 11 (1.1%) were CrAg positive. The CrAg positivity rate among patients with CD4 cell counts <100 cell/mm3 was 1.8%. Patients with CD4 cell counts <50 cells/mm3 had the highest CrAg rate (2.3%). CrAg prevalence was low but still warranted a CrAg screening and pre-emptive therapy approach for people infected with HIV with CD4 cell counts <100 cell/mm3 in Haiti.