Detection Of Antigen In Serum Research Articles

Invasive pulmonary aspergillosis evaluation in hematology patients: Three years results of tertiary hospital.

Invasive pulmonary aspergillosis (IPA) is the most frequent invasive fungal disease occurring in patients with hematological malignancies. Serum galactomannan (GM) antigen monitoring is thought to be helpful in the diagnosis of IPA. The aim of this study was to determine the role of a GM assay in serum samples for the diagnosis of IPA in patients with hematological disease. The data of 366 immunosuppressed patients that were hospitalized and followed up in the hematology clinic from January 2017 to December 2019 were retrospectively analyzed. The clinical and radiological findings of the patients and the GM results, requested twice a week, were evaluated. In this study, the incidence of probable and possible IPA was determined to be 15.3% (56/366). Of the cases detected, 28 (50.0%) were patients diagnosed with acute myeloid leukemia (AML), and 34 (60.7%) patients who had compatible clinical and examination findings were started on antifungal treatment. Additionally, area under the curve (AUC) values were calculated by receiver operating characteristic (ROC) analysis, and it was determined that the diagnostic efficiency was more predictive when the cut-off was 0.5 in the GM test for IPA disease. The detection of GM antigen in serum is a very useful and rapid method for diagnosing IPA disease in immunosuppressed hematology patients. However, GM results should be evaluated together with clinical and radiological findings for early diagnosis, and the treatment approach should be determined accordingly.

Molybdenum disulfide-based aptamer sensor for high-precision detection of prostate specific antigen in serum

As a representative transition metal dichalcogenide, molybdenum disulfide (MoS2) has unique electronic, optical, and mechanical properties that exhibit advantages in the construction of biosensing interfaces. In this study, we explored the construction of a MoS2-based aptamer sensor and investigated its application for high-precision detection of prostate specific antigen (PSA) in serum. Carboxyl group-modified MoS2 was stably bonded to the surface of an aminated electrode as a substrate structure, and the electrode was further modified with biocompatible membrane polydopamine and PSA aptamers to form an aminated screen-printed electrode/carboxylated MoS2/polydopamine (SPE-NH2/MoS2-COOH/PDA)-based aptamer sensor, which achieved ultrasensitive detection of PSA at 0.001 pg/mL ∼ 1 ng/mL with a limit of detection (LOD) of 0.16 fg/mL. The detection results of related interfering substances, such as L-cysteine, alpha fetoprotein (AFP), carcinoembryonic antigen (CEA) and bovine serum albumin (BSA), proved that the sensor had good selectivity. Then, repeated test results of multiple sensors verified that the aptamer sensors had good reproducibility between sensors. Finally, the practical application of the aptamer sensor was evaluated by a blank spiking method, which demonstrated its great clinical application potential. In summary, our study has provided ideas for the application of MoS2 composite-based aptamer sensing interfaces for potential precision medicine needs.

Meningeal cryptococcosis and SARS-CoV-2 infection in people living with HIV/AIDS.

Fungal infections in patients with COVID-19 was one of the most debated topics during the pandemic. To analyze the clinical characteristics and evolution of people living with HIV/AIDS and coinfection with cryptococcus and COVID-19 (group A) or without it (group B). This is an analytical and retrospective study. We reviewed medical records of patients with meningeal cryptococcosis between April 2020 and May 2021. We studied 65 people living with HIV/AIDS and with cryptococcosis infection diagnosed from April 2020 to May 2021. Fifteen patients with HIV/AIDS suffered from cryptococcosis and COVID-19, and out of these, 14 presented meningitis (group A), while 28 suffered from meningeal cryptococcosis, but did not have COVID-19 (group B). No statistically significant differences were observed between the two groups (A and B) considering: intracranial hypertension, presence of Cryptococcus antigens in cerebrospinal fluid, sensorium deterioration or mortality. The detection of Cryptococcus antigens in serum by lateral flow assay was highly effective to rapidly diagnose cryptococcosis in patients with HIV/AIDS who also developed COVID-19. Patients of both groups consulted for cryptoccocosis sometime after, in comparison with the pre-pandemic cases related to this infection.

Preemptive Therapy in Cryptococcosis Adjusted for Outcomes.

The aim of the study was to understand the development of patients diagnosed with cryptococcosis by detection of Cryptococcus antigen in serum by lateral flow assay (CrAg LFA) without nervous system involvement and with treatment in accordance with the results. A retrospective, longitudinal, analytical study was performed. Seventy patients with cryptococcosis initially diagnosed by serum CrAg LFA without meningeal involvement between January 2019 and April 2022 were analyzed for medical records. The treatment regimen was adapted to the results of blood culture, respiratory material, and pulmonary tomography imaging. Seventy patients were included, 13 had probable pulmonary cryptococcosis, 4 had proven pulmonary cryptococcosis, 3 had fungemia, and 50 had preemptive therapy without microbiological or imaging findings compatible with cryptococcosis. Among the 50 patients with preemptive therapy, none had meningeal involvement or cryptococcosis recurrences to date. Preemptive therapy avoided progression to meningitis in CrAg LFA-positive patients. Preemptive therapy with dose adjustment of fluconazole in patients with the mentioned characteristics was useful despite the use of lower doses than recommended.

Au–Se bonded nanoprobe for prostate specific antigen detection in serum

The detection of prostate specific antigen (PSA) in serum can realize early diagnosis of prostate cancer and prevent the occurrence of prostate tumors, as well as offering guidance during the therapy. Herein, a Au–Se bonded nanoprobes that can specifically detect PSA was designed and constructed. The peptide chains that can be specifically cleaved by PSA were firstly functionalized with fluorescent dye and selenol, and then bind to the Au nanoparticles to produce the probe. The dye's fluorescence was quenched due to the FRET effect, but recovered by PSA's cutting. The nanoprobe can detect PSA in serum with extraordinary anti-interference ability against other proteins (detection range 1–40 ng/mL). This work provides a new method for the detection of PSA in serum, and has potential guiding significance for clinical PSA detection.

Detection of canine distemper virus in stray and pet dogs in Mosul city, Iraq

The current work was carried out during the period from September, 2020 to March, 2021 in Mosul city, Iraq, with the objectives to detection of canine distemper virus (CDV) for the first time in Mosul using microscopic examination of blood smears, rapid serum antigen test and sandwich ELISA test as well as determine the agreement between the different diagnostic methods. A total of 92 blood samples were collected from suspected dogs with CDV (69 stray dogs and 23 Pet dogs). A primarily detection of CDV in blood smear by the presence of inclusion bodies in erythrocytes and leukocytes, followed by detection of CDV antigen in serum using rapid test and sandwich ELISA test. Results indicate that the infection rates of CDV in dogs were 32.6%, 13%, and 19.5% using microscopic examination, rapid test and sandwich ELISA test respectively. A statistically significant higher infection rate was reported in stray dogs compared to pet dogs based on all diagnostic tests used in this study. Based on Kappa values 0.413, 0.675, 0.745, there were moderate agreement between microscopic examination and rapid test, and substantial agreement between microscopic examination and sandwich ELISA test, also between rapid test and sandwich ELISA test respectively. In conclusions, CDV is widespread in dogs in Mosul city, Iraq and all tests used in this study are efficient for detection CDV based on compatibility between them.

Comparison of the Performance of Two Galactomannan Detection Tests: Platelia Aspergillus Ag and Aspergillus Galactomannan Ag Virclia Monotest.

ABSTRACTThe use of nonculture-based biomarkers such as the determination of galactomannan is sought for the diagnosis of invasive aspergillosis. To investigate the comparative yield of two tests for the detection of galactomannan in patients with or without proven or probable invasive aspergillosis. Overall, 327 samples (327 patients) were analyzed in a retrospective/prospective study performed in 3 hospitals in Madrid, comparing the determination results in serum or bronchoalveolar lavage of two techniques for galactomannan detection, namely, Platelia Aspergillus Ag (Bio-Rad) and Aspergillus galactomannan Ag Virclia Monotest (Vircell S.L.), following the manufacturer’s instructions. Both techniques can automate the process, but the second technique has the advantage of individual processing and assembly of each sample without the need for the additional expense of single-dose strips in controls. In total, 288 of the 327 tests performed showed concordant results between both techniques. The agreement between both methods was к = 0.722, and the correlation between indices was ρ = 0.718. Only 39 samples showed discordant results. In those 39 cases, there were 15 patients with proven or probable invasive aspergillosis criteria. For the samples with clinical criteria as a reference, the areas under the curve of the receiver operating characteristic (ROC) curve were 0.962 for Platelia and 0.968 for VirClia. The VirClia test has been proven to be an alternative for diagnosis due to its friendlier automated format than that of the usual Platelia routine test. The VirClia test also allows individual action and, therefore, a more immediate clinical response.IMPORTANCE Invasive mycoses are increasingly present in immunosuppressed or hospitalized patients with serious illnesses, leading to high rates of morbidity and mortality. Invasive aspergillosis is an infection caused, in a percentage greater than 50%, by the genus Aspergillus. It is vitally important to make an early diagnosis that leads to the application of antifungals in the initial stage of the infection. Therefore, tools are required to help with the early diagnosis of the infection. This comparative study of two enzyme immunoassays is based on the detection of galactomannan antigen in serum and bronchoalveolar lavage samples. A new design based on chemiluminescence and presented in an automated single-dose format is compared to a conventional ELISA technique marketed for years. The results obtained from the prospective and retrospective study indicate a high correlation and degree of agreement between both techniques, as well as in their diagnostic performance.

Stable DNA Aptamer-Metal-Organic Framework as Horseradish Peroxidase Mimic for Ultra-Sensitive Detection of Carcinoembryonic Antigen in Serum.

Carcinoembryonic antigen (CEA) is an important broad-spectrum tumor marker. For CEA detection, a novel type of metal–organic framework (MOF) was prepared by grafting CEA aptamer-incorporated DNA tetrahedral (TDN) nanostructures into PCN-222 (Fe)-based MOF (referred as CEAapt-TDN-MOF colloid nanorods). The synthesized CEAapt-TDN-MOF is a very stable detection system due to the vertex phosphorylated TDN structure at the interface, possessing a one-year shelf-life. Moreover, it exhibits a significant horseradish peroxidase mimicking activity due to the iron porphyrin ring, which leads to a colorimetric reaction upon binding toward antibody-captured CEA. Using this method, we successfully achieved the highly specific and ultra-sensitive detection of CEA with a limit of detection as low as 3.3 pg/mL. In addition, this method can detect and analyze the target proteins in clinical serum samples, effectively identify the difference between normal individuals and patients with colon cancer, and provide a new method for the clinical diagnosis of tumors, demonstrating a great application potential.

Performance of rapid diagnostic tests for hepatitis B surface antigen detection in serum or plasma

Hepatitis B surface antigen (HBsAg) is a key marker for screening and laboratory diagnosis of HBV infection. Rapid diagnostic tests (RDTs) represent promising alternatives to immunoassay-based methods because they are simple, fast and cheap. These tests, therefore, represent a powerful tool for large-scale screening and diagnosis of HBV infection in the clinical setting.Performance of 6 RDTs have been assessed in a large series of serum or plasma samples (n = 501) collected in France and in Cameroon.Specificity varied from 98.0% to 99.5%, while clinical sensitivity, compared to immunoassays as the reference, was excellent for all six RDTs (98.3%–99.3%). The VIKIA HBsAg and First Responseࣨ HBsAg Card Test reached sensitivity ≥99%. False-negative results were rare and mostly encompassed inactive HBsAg carriers or patients treated with nucleoside/nucleotide analogues.A number of RDTs may widely use to increase access to testing to all levels of the health care system.

Evaluation of a cryptococcal antigen lateral flow assay test for rapid detection of cryptococcal infection in HIV-negative patients in Ibadan, Nigeria

Background: A number of studies have been conducted in Nigeria on the prevalence of cryptococcal infections mostly on HIV-infected patients using culture, India ink and/or latex agglutination tests. These tests are either laborious, time-consuming and expensive or have low sensitivity, thus limiting their use. Cryptococcal antigen lateral flow assays (LFA) were introduced in the last decade as rapid user-friendly tests for diagnosis. In this study, we sought to determine the diagnostic accuracy of an LFA kit for the detection of cryptococcal antigen in the serum of HIV-negative patients with or without cerebrovascular accident (CVA) or stroke in University College Hospital, Ibadan, Nigeria.Methodology: The diagnostic accuracy of Dynamiker CrAg LFA was tested against BiosynexR CryptoPS on serum samples of 100 HIV-negative patients with and without stroke. Samples were tested and results interpreted in accordance with the manufacturer’s instructions. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive and negative likelihood ratios of the Dynamiker CrAg LFA were calculated by comparing with the BiosynexR CryptoPS as ‘gold standard’.Results: Overall, a total of 98 valid patient sample results were analysed; 17 samples (17.3%) were positive with Dynamiker CrAg LFA cryptococcal antigen and 16 samples (16.3%) were positive with BiosynexR CryptoPS. The sensitivity, specificity, PPV and NPV of Dynamiker CrAg LFA compared to the BiosynexR CryptoPS were 100%, 98.8%, 94.1% and 100% respectively, while the positive and negative likelihood ratios were 82 and 0 respectively.Conclusion: In comparison to the BiosynexR CryptoPS, the Dynamiker CrAg LFA is a highly sensitive and specific test for the detection of cryptococcal antigen in serum. The test kit should be considered as a screening device for cryptococcal infection both in outreach and clinical settings, especially in antiretroviral therapy (ART) centres.
 Keywords: Cryptococcus; evaluation; lateral flow assay; HIV-negative; stroke

Clinicopathological features of isolated pulmonary cryptococcosis in HIV-negative patients.

ObjectiveTo analyse the clinicopathological features of isolated pulmonary cryptococcosis in human immunodeficiency virus (HIV)-negative patients.MethodsThis retrospective study analysed the following data from HIV-negative patients diagnosed with pulmonary cryptococcosis: demographics, underlying diseases, clinical manifestations on admission, laboratory tests, imaging data, results of histopathology, treatment options and outcomes. Sputum samples from all patients were collected and assessed for the presence of yeast or fungi. Cryptococcal antigen testing was performed for some patients. Histopathological analysis was also undertaken for some samples of lung tissue.ResultsThe study analysed 37 patients (22 males). Thirteen (35.14%) patients were asymptomatic, 24 (64.86%) were symptomatic and 17 (45.95%) patients had no underlying disease. Out of 25 tested patients, 23 (92.00%) tested positive on the serum cryptococcal capsular polysaccharide antigen test. During 6 to 24 months of follow-up, all 37 patients that were either treated with or without antifungal therapy alone or combined with surgical resection showed complete recovery. One patient made a full recovery without any treatment.ConclusionEarly identification of pulmonary cryptococcosis in HIV-negative patients and timely detection of cryptococcal antigens in serum or respiratory specimens may help to improve diagnosis, prognosis and treatment of the disease.

Advances in Diagnosis of Progressive Pulmonary and Disseminated Coccidioidomycosis.

BackgroundAntibody detection is the main method for diagnosis of coccidioidomycosis, but it has limitations. The Coccidioides antigen enzyme immunoassay is recommended for testing cerebrospinal fluid in suspected meningitis. Reports on urine and serum antigen detection evaluated small numbers of patients who were mostly immunocompromised. The purpose of this study was to assess the accuracy of combined antibody and antigen detection for diagnosis.MethodsA retrospective study, including all patients in whom Coccidioides antigen detection in serum was performed between January 2013 and May 2017, was conducted at Valleywise Health Medical Center (formerly Maricopa Integrated Health System). Sensitivity and specificity of antigen and antibody were evaluated in 158 cases and 487 controls.ResultsThe sensitivity of antibody detection by immunodiffusion (ID) was 84.2%. The sensitivity of antigen detection was 57.0% if both urine and serum were tested and 36.7% if urine alone was tested. The sensitivity of combining antigen and ID antibody detection was 93.0%. The sensitivity of urine and serum antigen detection was 55.4% in proven and 58.7% in probable cases, 79.1% in disseminated and 41.6% in pulmonary cases, and 74.7% in immunocompromised and 40.0% in immunocompetent patients. Specificity was 99.4% for antigen detection and 96.5% for ID antibody detection. Diagnostic accuracy was 95.4% for ID antibody and antigen detection, 93.6% for ID antibody alone, and 89.1% for pathology or culture.ConclusionsThese findings support combined antibody and antigen detection for diagnosis of progressive coccidioidomycosis. The diagnosis may have been missed if antigen detection was not performed.

Performance Enhancement of Biomolecule Detection in ZnO Thin-Film Transistor by Noise Spectroscopy Measurements

In this paper, effectiveness of noise spectroscopy measurements have been investigated for enhancing the reliability of biomolecule detection in complex analyte like serum using zinc oxide (ZnO) thin film transistor (TFT). Different gate voltages have been applied to study the noise spectrum after the capture of a specific Hep-B surface antigen (HBsAg). It has been observed that the noise spectrum exhibits a Lorentzian behavior after biomolecule capture with a distinct corner frequency at an optimum gate voltage of 0.5V. This has been attributed to significant modulation in drain current upon biomolecule capture along with a low device noise. The corner frequencies for different concentration of biomolecules are considerably less overlapping in serum compared to drain current sensitivities which has resulted in antigen detection down to 1fM within an error of ±5%. The present study lowers the detection limit by more than one order of magnitude compared to the existing reports of antigen detection in serum using ZnO nanostructures.

Precise detection of prostate specific antigen in serum: A surface molecular imprinted sensor based on novel cooperated signal amplification strategy

Prostate specific antigen (PSA) is of great significance for clinical detection. Herein, a surface molecular imprinted sensor based on a novel cooperated signal amplification strategy was constructed for the precise detection of PSA. MoS2 and gold nanoparticles were modified on the electrode surface as the sensing substrate, PSA template and 4-mercaptophenylboronic acid were employed to form the surface imprinted cavities, and the gold polymerized methylene blue composites labeled 4-mercaptophenylboronic acid was constructed as the tracing tag. Cyclic voltammetry, electrochemical impedance spectroscopy and differential pulse voltammetry measurements were performed to investigate the formation process of the sensor. Transmission electron microscopy, scanning electron microscopy and energy dispersive spectrometer analysis were utilized for the characterization of the sensing substrate and tracing tag. Once the target PSA was anchored on the sensor, an amplified signal was obtained by the cooperated electrochemical catalytic interaction of the nanomaterials on the tracing tag and substrate. The constructed sensor showed a wide linear range from 1.0 × 10−4 to 1.0 × 104 ng·mL-1, and the detection limit was 0.03 pg·mL-1. Besides, such a sensor exhibited favorable selectivity, reproducibility and stability in the assays, indicating an expected application prospect in the determination of tumor markers.

Performance of a Sandwich Antigen-Detection ELISA for the Diagnosis of Porcine Taenia solium Cysticercosis.

The pig is the natural intermediate host of Taenia solium, a parasite causing significant burden of disease in both humans and pigs. Porcine cysticercosis is traditionally detected via tongue palpation and slaughterhouse meat inspection, both with limited sensitivity. Serum antibody detection has a better performance; however, it does not discriminate past from present infection. Serum antigen detection can demonstrate viable infection and gives a good estimate of parasitic load. This study evaluated a sandwich antigen-detection ELISA using monoclonal antibodies (MoAbs) 158C11 and 60H8 for the diagnosis of viable cysticercosis in pigs. Serum samples were used from 35 naturally T. solium cysticerci-infected pigs, 31 cysticercosis-negative pigs, and 22 pigs with Taenia hydatigena infection (to assess cross-reactions). Positive cysticercosis samples were subcategorized at necropsy according to parasitic burden as mild (1-10 viable cysts, n = 10), moderate (11-100 cysts, n = 5), or severe infection (more than 100 cysts, n = 20). This Ag-ELISA showed a sensitivity of 82.9% and a specificity of 96.8% when not considering cross-reactions with T. hydatigena. Hundred percentage of severely infected, 80% of moderately infected, and 50% of mildly T. solium-infected pigs tested positive. Twenty of 22 pigs with only T. hydatigena infections were positive, with 13 reaching saturating levels in the ELISA. The Ag-ELISA revealed the presence of live cysts and is, thus, a fairly reliable test to monitor experimental infection, response to treatment, and follow-up in animal models of cysticercosis. It should, however, be carefully interpreted when used in regions where T. hydatigena is endemic in pigs.

Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area

BackgroundHIV-associated immune defects inhibit tuberculosis (TB) diagnosis, promote development of extrapulmonary TB and paucibacillary pulmonary TB cases with atypical radiographic features, and increase TB relapse rates. We therefore assessed the diagnostic performance of a novel assay that directly quantitates serum levels of the Mycobacterium tuberculosis (Mtb) virulence factor 10-kDa culture filtrate protein (CFP-10) to overcome limitations associated with detecting Mtb bacilli in sputum or tissue biopsies.MethodsThis study analyzed HIV-positive adults enrolled in a large, population-based TB screening and surveillance project, the Houston Tuberculosis Initiative, between October 1995 and September 2004, and assigned case designations using standardized criteria. Serum samples were trypsin-digested and immunoprecipitated for an Mtb-specific peptide of CFP-10 that was quantified by liquid chromatography-mass spectrometry for rapid and sensitive TB diagnosis.ResultsAmong the 1053 enrolled patients, 110 met all inclusion criteria; they included 60 tuberculosis cases (12 culture-negative TB), including 9 relapse TB cases, and 50 non-TB controls, including 15 cases with history of TB. Serum CFP-10 levels diagnosed 89.6% (77.3–96.5) and 66.7% (34.9–90.1) of culture-positive and culture-negative TB cases, respectively, and exhibited 88% (75.7–95.5) diagnostic specificity in all non-TB controls. Serum antigen detection and culture, respectively, identified 85% (73.4–92.9) and 80.0% (67.3–88.8) of all 60 TB cases.ConclusionsQuantitation of the Mtb virulence factor CFP-10 in serum samples of HIV-infected subjects diagnosed active TB cases with high sensitivity and specificity and detected cases missed by the gold standard of Mtb culture. These results suggest that serum CFP-10 quantitation holds great promise for the rapid diagnosis of suspected TB cases in patients who are HIV-infected.

USEFULNESS OF AN ELISA KIT FOR THE DETECTION OF Histoplasma capsulatum ANTIGEN IN PATIENTS WITH AIDS

Histoplasmosis is a systemic mycosis frequently affecting patients infected with HIV, appearing as acute or subacute disseminated forms. Early diagnosis is simple when muco-cutaneous lesions are present; but in their absence the use of non-culture based methods is usually required presenting a fundamental challenge for the management and prognosis of this infection. The aim of this study was to analyze the sensitivity and specificity of an Elisa kit for the detection of the galactomannan antigen of Histoplasma capsulatum in different clinical samples. A total of 98 clinical samples obtained from different organic fluids were analyzed: 66 sera, 28 urine samples, 3 bronchoalveolar lavages and one cerebrospinal fluid. They corresponded to a total of 61 patients: 27 with histoplasmosis associated with AIDS, 7 histoplasmosis in nonreactive HIV individuals and 27 patients with other diseases but which were clinically similar to histoplasmosis. The sensitivity of the detection of the galactomannan antigen in serum of patients with histoplasmosis and AIDS was 76% and the specificity was 56%. In urine samples of this group of patients the sensitivity was 75%.

Antigen Detection in the Diagnosis of Histoplasmosis: A Meta-analysis of Diagnostic Performance.

We performed a meta-analysis of diagnostic data to evaluate the performance of Histoplasma antigen detection tests for diagnosing histoplasmosis. We included all studies involving human subjects that assessed the performance of any antigen detection test for histoplasmosis in urine or serum by carrying out an exhaustive and reproducible search of the literature between 1980 and 2014 from four databases. Quality of the articles was assessed, and meta-analysis was performed under the random effects model, calculating sensitivity, specificity, likelihood and odds ratios, and ROC curve using Meta-DiSc(es). Nine out of a total of 23 studies met strict quality criteria and were therefore included. The overall sensitivity for antigen detection in serum and urine was 81% (95% CI 78-83%), while specificity was 99% (95% CI 98-99%). Sensitivity for antigenuria and antigenemia was 79% (95% CI 76-82%) and 82% (95% CI 79-85%), respectively; specificity values were 99% (95% CI 98-100%) in urine and 97% (95% CI 96-98%) in serum. The positive and negative likelihood ratios were 49.5 (95% CI 20.7-118.7) and 0.19 (95% CI 0.14-0.26), respectively, while the diagnostic OR was 362 (95% CI 121.2-1080.3) and area under the curve was 0.99. In conclusion, the performance of Histoplasma antigen detection assay of urine was not significantly different from that of blood, indicating that antigenuria and antigenemia have equal diagnostic value in histoplasmosis.

La cryptococcose au cours de l’infection à VIH

Cryptococcosis is a cosmopolitan fungal serious condition due to an encapsulated yeast Cryptococcus neoformans. This is the systemic fungal infection the most common in HIV infection. This yeast is present in the environment and its main entrance in the body is the respiratory tract. Its gravity is linked to its tropism for the central nervous system. It generally affects subjects with severe deficit of cellular immunity and in particular, patients living with HIV. The diagnosis of neuromeningeal cryptococcosis is based on the detection of encapsulated yeasts at microscopic examination of cerebrospinal fluid, the detection of capsular polysaccharide antigen in serum or cerebrospinal fluid, but especially on the culture. A staging is always essential. The prognosis is severe. The control of intracranial hypertension is a major element of prognosis.

Nonspecific elevation of serum Aspergillus galactomannan antigen levels in patients with rheumatoid arthritis.

Infections are an important cause of morbidity and mortality in patients with rheumatoid arthritis. Patients receiving immunosuppressive or anti-tumor necrosis factor (TNF) agents are vulnerable to fungal infections, including those derived from Aspergillus species. Detection of the Aspergillus galactomannan antigen in serum is useful for the early diagnosis of invasive aspergillosis in patients with hematological malignancies. However, its usefulness for detecting early invasive aspergillosis in rheumatoid arthritis patients remains unestablished. Galactomannan antigen levels were measured in 340 patients (311 female patients). For patients who exhibited galactomannan antigen levels ≥0.5 during the initial examination, a second examination was performed 3-6 months later. Conventional blood tests and chest radiography were also performed. Elevated galactomannan antigen levels (≥0.5) were observed in 62 (18.2%) of 340 patients during the initial examination. A second examination was performed in 56 of 62 patients, 50 of whom exhibited elevated antigen levels. Elevated antigen levels were not associated with the use of any drug including anti-TNF agents. Serum galactomannan antigen levels were correlated with the albumin/globulin ratio (r=-0.19, p<0.001), γ-globulin (%; r=0.17, p=0.001), and hemoglobin concentration (r=-0.15, p=0.005). No patient was clinically diagnosed with invasive aspergillosis during the study period. Serum galactomannan antigen levels are frequently elevated in a nonspecific manner in patients with rheumatoid arthritis.