Abstract
Cryptococcal infection is a major cause of opportunistic infection in HIV/AID‐infected peoples. We determined cryptococcal antigenemia and cryptococcal meningitis among antiretroviral therapy (ART) initiated and ART‐naive HIV‐infected peoples. A cross‐sectional study was conducted at selected health facilities in Mekelle, Ethiopia. Blood was collected to determine CD4 and plasma cryptococcal antigen (CrAg). CSF CrAg and CSF culture and urease tests were also done. Socio‐demographic and clinical data were collected using a structured questionnaire and clinical chart review. From the enrolled study participants, 267 study participants had complete data, of which, 137 (51%) were females. From the study participants, 140 (52%) and 127 (48%) were ART experienced and ART naïve, respectively. The prevalence of cryptococcal antigenemia was 9 (3.4%). All the study participants, except one (CD4 = 120 cells/mm3), had CD4 count less than 100 cells/mm3. From CrAg‐positive peoples, 6 (4.7%) were ART naïve. Five CrAg‐positive peoples had cryptococcal meningitis. Being male, rural residence, and being hospitalized were associated with cryptococcal antigenemia. Cryptococcal infection poses a substantial risk of HIV‐positive peoples. This study provides relevant data for CrAg screening interventions in patients with low CD4 cell counts.
Highlights
Cryptococcal infection is a major cause of opportunistic infection in HIV/AIDS‐infected peoples
The prevalence of cryptococcosis is high in Africa, especially in sub‐ Saharan Africa, where it is found up to 28% of HIV‐infected patients with clinical signs of meningitis (Ngouana et al, 2015)
Lumbar puncture was performed on those 6 study participant, of which, only 5 were positive for cerebrospinal fluid (CSF) lateral flow assay (LFA) cryptococcal antigen (CrAg) test
Summary
Cryptococcal infection is a major cause of opportunistic infection in HIV/AIDS‐infected peoples. The subclinical infectious state is known to precede clinically apparent disease by weeks to months, which eventually will lead to meningitis and mortality in HIV‐infected people (Centers for disease control and Prevention (CDC), 2014; Meya et al, 2015; Rajasingham, Meya, & Boulware, 2012). In Africa, crypto‐ coccal‐related infections place a high burden on healthcare resources It causes a severe and often fatal meningoencephalitis in people living with HIV/AIDS, accounting for 42% to 71% of neuromeningeal crypto‐ coccosis‐related deaths in sub‐Saharan Africa (Assogoba et al, 2015). High prevalence of cryptococcal antigenemia has been reported in ART sites in Addis Ababa and Adama (Alemu et al, 2013; Beyene et al, 2013, 2017 ). This study is aimed at determining the cryp‐ tococcal antigenemia and associated factors among ART naïve and ART‐experienced HIV‐infected peoples
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