Abstract
Preheating of urine improves the specificity of urinary cryptococcal antigen testing using the lateral flow assay.
Highlights
Cryptococcosis by Cryptococcus neoformans is a major opportunistic infection in HIV patients, responsible for a high lethality (13%–44%), mainly in resource-limited countries
In Brazil, besides cryptococcosis associated with HIV, another public health problem is the endemic occurrence of cryptococcal meningitis by C. gattii in north and northeast regions with a lethality rate of 35%–40% [2]
Diagnosis and treatment is an important strategy for preventing clinical disease and reducing the high lethality rate in HIV patients with detectable CrAg
Summary
Cryptococcosis by Cryptococcus neoformans is a major opportunistic infection in HIV patients, responsible for a high lethality (13%–44%), mainly in resource-limited countries. Early diagnosis is the key to decrease the high lethality rate due to cryptococcosis. Previous studies that used a cryptococcal antigen lateral flow assay (CrAg LFA) Immy in serum, plasma, finger stick whole blood, and cerebrospinal fluid (CSF) demonstrated its high sensitivity and specificity for screening cryptococcosis [3,4]. A urine sample is easier to obtain than blood or CSF, becoming a promising methodology for early diagnosis of cryptococcosis, especially in developing countries [3,4]. Considering that the Cryptococcus target molecule glucuronoxylomannan (GXM) is thermostable, we included a heating step before the CrAg LFA Immy test to overcome the false positive results in urine, as shown in previous studies
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