Cryptococcal antigenaemia amongst HIV infected children in Owerri, South East Nigeria

Abstract

Objective: Cryptococcosis is an opportunistic infection caused by Cryptococcus and can result in cryptococcal meningitis, which is an AIDS-defining condition associated with high morbidity and mortality. Although a high prevalence of Cryptococcal antigenemia (CrAg) preceding cryptococcal disease has been reported in HIV-infected Nigerian adults, it is more common in patients with low CD4, stage 3 or 4 HIV. However, there is only one study on Cryptococcal antigenemia in HIV-infected Nigerian children. Therefore, this study aimed to determine the burden of cryptococcosis in HIV-infected children. Material and Methods: This study was a hospital-based cross-sectional study conducted between October 2018 and January 2019 at the Pediatric Infectious Disease Clinic of the Federal Medical Centre, Owerri. The study population consisted of HIV-infected children (aged 2-16 years) attending the clinic. The subjects were recruited consecutively and underwent a thorough physical examination and anthropometric measurements before a single blood sample was taken. Cryptococcal antigen was assayed using the Lateral Flow Assay method, and CD4+ counts were assayed using cyflow. Results: A total of 100 children were involved in the study, of which 51 (51%) were female and 49 (49%) were male (M:F, 1:1). The average age of the participants was 9.73 ± 3.12 years. Among the 100 children tested, there was no cryptococcal antigenemia (0%). Statistical analysis was limited to simple description. Conclusion: Cryptococcosis is not a common opportunistic infection among HIV-infected children attending the Pediatric Infectious Disease Clinic in Federal Medical Centre Owerri. Therefore, it may not be considered as a differential diagnosis for HIV-positive children with meningoencephalitis.