RT Journal Article
T1 Cryptococcal infection in HIV-infected patients with CD4+ T-cell counts under 100/μL diagnosed in a high-income country: a multicentre cohort study.
A1 Pérez-Jacoiste Asín, María Asunción
A1 Bisbal, Otilia
A1 Iribarren, José Antonio
A1 Pérez-Rivilla, Alfredo
A1 Mican, Rafael
A1 Dronda, Fernando
A1 González-Domenech, Carmen María
A1 Vinuesa-García, David
A1 Macías, Juan
A1 Lumbreras, Carlos
A1 Moreno, Santiago
A1 Rubio, Rafael
A1 members of the Cohorte de la Red de Investigación en Sida (CoRIS), 
K1 CD4(+)T-cell count
K1 Cryptococcal antigen
K1 Cryptococcal infection
K1 HIV
K1 High-income countries
AB The World Health Organization recommends routinely screening HIV-infected patients with CD4+ T-cell counts  We determined CrAg using a lateral flow assay in banked plasma from participants in the cohort of the Spanish AIDS Research Network. Eligible patients had CD4+ T-cell counts ≤100/μL at the time of plasma collection and a follow-up >4 weeks, unless they died. We included 576 patients from June 2004 to December 2017. Of these, 43 were CrAg+ for an overall prevalence of 7.5%. There were no differences depending on birthplace. The CrAg+ was independently associated with a higher mortality at eight weeks (hazard ratio (HR) 5.36, 95% confidence interval (CI) 1.46-19.56) and 6 months (HR 3.12, 95% CI 1.19-8.21). CM was reported in 10 of the 43 CrAg+ patients. There were no cases among negatives. Five patients had CM when the plasma was collected and five developed it during the follow-up. The number of subjects needed to screen to anticipate the diagnosis of one CM case was 114. The CrAg+ prevalence among HIV-infected patients with CD4+ T-cell counts ≤100/μL diagnosed in Spain, both immigrants and native-born Spanish, is >7%. Consequently, the Spanish AIDS Study Group guidelines have to be updated and recommend routine screening for cryptococcal infection in these patients. Future studies should explore whether this recommendation could be firmly applied to other European populations.
YR 2020
FD 2020-10-16
LK http://hdl.handle.net/10668/16440
UL http://hdl.handle.net/10668/16440
LA en
DS RISalud
RD Apr 7, 2025