Asella Teaching Hospital, College of Health Sciences, Arsi University.
Hirsch-Institute of Tropical Medicine Research Centre, Asella, Ethiopia.
Clin Infect Dis. 2017 Nov 29;65(12):2126-2129. doi: 10.1093/cid/cix613.
A total of 817 human immunodeficiency virus-infected Ethiopians with CD4 <150 cells/mL underwent plasma cryptococcal antigen (CRAG) screening. CRAG prevalence was 6.2%. Of participants with plasma CRAG titers >1:640, 96% (27 of 28) had cryptococcal meningitis (cerebrospinal fluid CRAG-positive) whereas 50% (7 of 14) with 1:160-1:320 titers had meningitis. With fluconazole 1200 mg/d therapy, 68% of meningitis patients (23 of 34) died within 3 months. Plasma CRAG titers >1:160 predict meningitis, requiring more intensive antifungal therapy.
共有 817 名 CD4 细胞<150 个/毫升的艾滋病毒感染者接受了血浆隐球菌抗原(CRAG)筛查。CRAG 的患病率为 6.2%。在血浆 CRAG 滴度>1:640 的参与者中,96%(27/28)患有隐球菌性脑膜炎(脑脊液 CRAG 阳性),而滴度为 1:160-1:320 的参与者中有 50%(7/14)患有脑膜炎。在氟康唑 1200mg/d 治疗中,68%(23/34)的脑膜炎患者在 3 个月内死亡。血浆 CRAG 滴度>1:160 预测脑膜炎,需要更强化的抗真菌治疗。