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Preventing Cryptococcosis—Shifting the Paradigm in the Era of Highly Active Antiretroviral Therapy
Cryptococcosis remains a significant cause of morbidity and mortality among HIV-infected patients, especially in sub-Saharan Africa where it causes up to 20 % of AIDS-related deaths in HIV programs. A new, highly sensitive, and affordable point of care diagnostic test for cryptococcal infection, the...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4412515/ https://www.ncbi.nlm.nih.gov/pubmed/25960942 http://dx.doi.org/10.1007/s40475-015-0045-z |
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author | Meya, David Rajasingham, Radha Nalintya, Elizabeth Tenforde, Mark Jarvis, Joseph N |
author_facet | Meya, David Rajasingham, Radha Nalintya, Elizabeth Tenforde, Mark Jarvis, Joseph N |
author_sort | Meya, David |
collection | PubMed |
description | Cryptococcosis remains a significant cause of morbidity and mortality among HIV-infected patients, especially in sub-Saharan Africa where it causes up to 20 % of AIDS-related deaths in HIV programs. A new, highly sensitive, and affordable point of care diagnostic test for cryptococcal infection, the lateral flow assay, can detect early sub-clinical cryptococcosis especially in areas with limited laboratory infrastructure. With a prevalence of detectable sub-clinical cryptococcal infection averaging 7.2 % (95 % CI 6.8–7.6 %) among 36 cohorts with CD4 <100 cells/μL in Africa, together with data showing that preemptive fluconazole prevents overt cryptococcal disease in this population, implementing a screen and treat strategy as part of HIV care practice among patients with CD4 <100 cells/μL could prevent the incidence of often fatal cryptococcal meningitis in the setting of the HIV pandemic. |
format | Online Article Text |
id | pubmed-4412515 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-44125152015-05-06 Preventing Cryptococcosis—Shifting the Paradigm in the Era of Highly Active Antiretroviral Therapy Meya, David Rajasingham, Radha Nalintya, Elizabeth Tenforde, Mark Jarvis, Joseph N Curr Trop Med Rep Tropical Mycosis (D Boulware, Section Editor) Cryptococcosis remains a significant cause of morbidity and mortality among HIV-infected patients, especially in sub-Saharan Africa where it causes up to 20 % of AIDS-related deaths in HIV programs. A new, highly sensitive, and affordable point of care diagnostic test for cryptococcal infection, the lateral flow assay, can detect early sub-clinical cryptococcosis especially in areas with limited laboratory infrastructure. With a prevalence of detectable sub-clinical cryptococcal infection averaging 7.2 % (95 % CI 6.8–7.6 %) among 36 cohorts with CD4 <100 cells/μL in Africa, together with data showing that preemptive fluconazole prevents overt cryptococcal disease in this population, implementing a screen and treat strategy as part of HIV care practice among patients with CD4 <100 cells/μL could prevent the incidence of often fatal cryptococcal meningitis in the setting of the HIV pandemic. Springer International Publishing 2015-04-21 2015 /pmc/articles/PMC4412515/ /pubmed/25960942 http://dx.doi.org/10.1007/s40475-015-0045-z Text en © The Author(s) 2015 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Tropical Mycosis (D Boulware, Section Editor) Meya, David Rajasingham, Radha Nalintya, Elizabeth Tenforde, Mark Jarvis, Joseph N Preventing Cryptococcosis—Shifting the Paradigm in the Era of Highly Active Antiretroviral Therapy |
title | Preventing Cryptococcosis—Shifting the Paradigm in the Era of Highly Active Antiretroviral Therapy |
title_full | Preventing Cryptococcosis—Shifting the Paradigm in the Era of Highly Active Antiretroviral Therapy |
title_fullStr | Preventing Cryptococcosis—Shifting the Paradigm in the Era of Highly Active Antiretroviral Therapy |
title_full_unstemmed | Preventing Cryptococcosis—Shifting the Paradigm in the Era of Highly Active Antiretroviral Therapy |
title_short | Preventing Cryptococcosis—Shifting the Paradigm in the Era of Highly Active Antiretroviral Therapy |
title_sort | preventing cryptococcosis—shifting the paradigm in the era of highly active antiretroviral therapy |
topic | Tropical Mycosis (D Boulware, Section Editor) |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4412515/ https://www.ncbi.nlm.nih.gov/pubmed/25960942 http://dx.doi.org/10.1007/s40475-015-0045-z |
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