Eric Ebonu, Olupot-Olupot Peter, Bwayo Denis, Meya David, Katuramu Richard
Mbale Regional Referral Hospital, Department of Internal Medicine, Mbale city, Uganda.
Busitema University Faculty of Health Sciences, Department of internal Medicine, Mbale city, Uganda.
Open Forum Infect Dis. 2023 Jul 19;10(7):ofad351. doi: 10.1093/ofid/ofad351. eCollection 2023 Jul.
Cryptoccocal infection remains an important cause of morbidity and mortality among people with advanced human immunodeficiency virus disease (AHD). In resource-limited settings, there is a paucity of data on cryptoccocal infections. We described the prevalence and factors associated with cryptoccocal antigenemia among people with AHD in Mbale Regional Referral Hospital in Eastern Uganda.
In this cross-sectional study, data on sociodemographic, clinical, and laboratory characteristics of adults with AHD were collected, and factors associated with cryptoccocal antigenemia were determined using multivariate logistic regression models.
We enrolled 228 participants with a median CD4 cell count of 194/µL (interquartile range, 129-370/µL). The prevalence of cryptoccocal antigen was 10 in 228 (4.4% [95% confidence interval, 2.4%-80%]). CD4 cell counts <100/µL (adjusted odds ratio, 3.70) and poultry keeping were risk factors. The main predictors were headaches (adjusted odds ratio, 1), neck pains (8.817), confusion (6.323), and neck stiffness (676.217). No notable significant associations were found in the multivariate analysis.
The prevalence of cryptoccocal antigen was 4.4%, and antiretroviral therapy was protective.
隐球菌感染仍是晚期人类免疫缺陷病毒病（AHD）患者发病和死亡的重要原因。在资源有限的环境中，关于隐球菌感染的数据匮乏。我们描述了乌干达东部姆巴莱地区转诊医院AHD患者中隐球菌抗原血症的患病率及相关因素。
在这项横断面研究中，收集了AHD成年患者的社会人口统计学、临床和实验室特征数据，并使用多变量逻辑回归模型确定与隐球菌抗原血症相关的因素。
我们纳入了228名参与者，其CD4细胞计数中位数为194/µL（四分位间距，129 - 370/µL）。228例中有10例隐球菌抗原阳性（4.4%[95%置信区间，2.4% - 8.0%]）。CD4细胞计数<100/µL（调整比值比，3.70）和饲养家禽是危险因素。主要预测因素为头痛（调整比值比，1）、颈部疼痛（8.817）、意识模糊（6.323）和颈部僵硬（676.217）。多变量分析中未发现显著关联。
隐球菌抗原患病率为4.4%，抗逆转录病毒疗法具有保护作用。
