Cryptococcal antigen prevalence in HIV patients from a tertiary care centre in South India

Area of Science:

• Medical Mycology
• Infectious Diseases
• Public Health

Background:

• Cryptococcosis, caused by *Cryptococcus neoformans*, is a severe opportunistic infection.
• Cryptococcal meningitis is a leading cause of mortality in individuals with human immunodeficiency virus (HIV).
• Understanding the prevalence of cryptococcal antigenemia and other opportunistic infections in people living with HIV (PLHA) is crucial for clinical management.

Purpose of the Study:

• To determine the prevalence of cryptococcal antigenemia in PLHA in Kerala, India.
• To identify the common opportunistic infections among HIV-positive patients.
• To assess the potential utility of routine cryptococcal antigen screening in this demographic.

Main Methods:

• A total of 204 HIV-positive individuals over 18 years old with CD4 counts below 300 cells/mm³ were enrolled.
• Cryptococcal antigen detection was performed using the CrAg Lateral Flow Assay.
• Prevalence of other opportunistic infections was also documented.

Main Results:

• No cases of cryptococcal antigenemia were detected in the study cohort.
• Opportunistic infections were present in 40.2% of the participants.
• Candidiasis, tuberculosis, and *Pneumocystis jiroveci* pneumonia were the most frequently observed opportunistic infections.

Conclusions:

• Routine screening for cryptococcal antigenemia may not be cost-effective in the studied population in Kerala.
• While candidiasis, tuberculosis, and PCP were more common in individuals with CD4 counts < 200 cells/mm³, no statistically significant association was found.
• This study provides initial data on cryptococcal antigenemia prevalence among PLHA in southern India.