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Related Experiment Video

Updated: Jul 25, 2025

Passive Administration of Monoclonal Antibodies Against H. capsulatum and Others Fungal Pathogens
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Preemptive Therapy in Cryptococcosis Adjusted for Outcomes.

Fernando Messina1, Gabriela Santiso1, Alicia Arechavala1

  • 1Mycology Unit, Infectious Diseases Hospital F.J. Muñiz, Buenos Aires C1282AEN, Argentina.

Journal of Fungi (Basel, Switzerland)
|June 27, 2023
PubMed
Summary

Early detection of Cryptococcus antigen (CrAg LFA) in HIV patients and preemptive therapy can prevent cryptococcal meningitis. This study shows preemptive treatment is effective, even with adjusted fluconazole doses.

Keywords:
Cryptococcuscryptococcal antigenemiacryptococcal screeninglateral flow assaypreemptive therapyserum cryptococcal antigen

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Area of Science:

  • Infectious Diseases
  • Mycology
  • HIV Medicine

Background:

  • Cryptococcosis is a severe opportunistic infection in people with HIV.
  • Early diagnosis and treatment are crucial for managing cryptococcosis.
  • Cryptococcal antigen lateral flow assay (CrAg LFA) aids in early detection.

Purpose of the Study:

  • To evaluate the outcomes of HIV patients diagnosed with cryptococcosis via serum CrAg LFA.
  • To assess the effectiveness of preemptive therapy in patients without nervous system involvement.
  • To analyze treatment regimens adapted to diagnostic findings.

Main Methods:

  • Retrospective, longitudinal, analytical study of 70 HIV patients diagnosed with cryptococcosis by serum CrAg LFA.
  • Analysis of medical records from January 2019 to April 2022.
  • Treatment guided by blood culture, respiratory samples, and pulmonary imaging.

Main Results:

  • Fifty patients received preemptive therapy without microbiological or imaging evidence of active cryptococcosis.
  • None of the 50 patients on preemptive therapy developed meningitis or recurrence.
  • Pulmonary cryptococcosis was diagnosed in 17 patients, and fungemia in 3.

Conclusions:

  • Preemptive therapy effectively prevented meningitis progression in CrAg LFA-positive patients.
  • Adjusted-dose fluconazole preemptive therapy proved beneficial, even at lower doses.
  • Early CrAg LFA screening and preemptive management are vital for HIV-associated cryptococcosis.