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Published on: June 11, 2011
Increased mortality among HIV infected patients with cryptococcal antigenemia in Guinea-Bissau
Ditte Thomsen1,2, Cecilie Juul Hviid3, Bo Langhoff Hønge1,2,3
1Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau.
Abstract:
Cryptococcal antigenemia may precede development of cryptococcal meningitis and death among patients with advanced HIV infection. Among 200 retrospectively and randomly selected ART-naïve patients with CD4 counts < 100 cells/μl from Guinea-Bissau, 20 (10%) had a positive cryptococcal antigen test. Self-reported headache and fever were predictors of a positive test, while cryptococcal antigenemia was a strong predictor of death within the first year of follow-up, MRR 2.22 (95% CI: 1.15-4.30). Screening for cryptococcal antigenemia should be implemented for patients with advanced HIV in Guinea-Bissau. Pre-emptive anti-fungal therapy should be initiated prior to ART-initiation if the screening is positive.
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