There is No Cryptococcal Antigenaemia among A Cohort of Children with Advanced HIV Infection in an Antiretroviral Therapy Programme in Makurdi, Nigeria

Abstract

Introduction: Cryptococcal disease is an important opportunistic infection and a major contributor to mortality in HIV/AIDS. Unfortunately, there has been no data describing the burden of cryptococcosis in Nigerian HIV-infected children. Methods: A cross-sectional study between January 2013 to September 2013 at the Federal Medical Centre, Makurdi to determine the prevalence and risk factors of cryptococcal antigenaemia among a cohort of consecutive HIV-infected children (≤15 years of age) with a CD4 count of ≤200 cells/mm3, including treatment-naive and those on Antiretroviral Therapy (ART). The cryptococcal antigen Lateral Flow Assay method was used twice on each sample collected from the children. Results: A total of 699 children were seen but only 88 children had CD4 count of ≤200 cell/mm3. These 88 subjects included 47 Males and 41 Females (M: F, 1:0.9). The age range was from 12-168 months with a mean of 73.23 ± 41.06 months. The CD4 count was from 10 to 198 cells/mm3 with a median of 104 cells/mm3 (Interquartile range, IQR; 53- 157). Twenty (20/88, 22.7%) children had a CD4 count of less than 50 cells/mm3, 24 (27.3%) had CD4 counts between 51-100, and 44 children (50%) had CD4 counts between 101-198 cell/mm3. The median viral load was 3,016 copies/ ml with an IQR of 200-39,354 copies/ml. Only 11 (12.5%) children were not on HAART. There was no cryptococcal antigenaemia (0%) among the 88 children tested. Statistical analysis was thus limited to simple description. Conclusion: In our setting, cryptococcosis may not be a strong consideration in the differential diagnosis of severely immunosuppressed HIV-infected children (≤15 years of age) presenting with pneumonia and or meningoencephalitis