Prevalence of Cryptococcaemia in HIV Infected Patients with CD4 Counts of ≤100 Cells/mm3-A Cross Sectional Study in a Tertiary Care Hospital

Document Type : Original Research

Authors
P. Kaur 1
J. Kaur 2
1 Department of Microbiology, SGRD institute of Medical Sciences and Research, Amritsar, India
2 Department of Microbiology, SGRD institute of Medical Sciences and Research, Amritsar, India.
10.52547/iem.8.1.53
Abstract
Backgrounds: This study aimed to investigate the prevalence of cryptococcaemia in HIV infected patients with CD4 counts of ≤100 cells/mm3 in a tertiary care hospital.

Materials & Methods: The present cross sectional study was conducted at the Sri Guru Ram Das Institute of Health Sciences and Research, India, as a tertiary care hospital. All HIV infected patients with CD4 counts of ≤100 cells/mm3, referring to the hospital during May 2020 to May 2021 were enrolled in this study. Blood samples taken from patients were processed for wet mounting, negative staining with India ink, gram staining, fungal culture, and cryptococcal antigen (CrAg) lateral flow assay (LFA). Statistical analysis was done using SPSS software Version 20.0 (SPSS Inc. Chicago, IL, USA) by employing Chi-square and Fisher’s exact tests to compare categorical variables.

Findings: Out of 100 patients enrolled, 28 (28%) cases had CD4 counts below 50, while 72 (84.7%) patients had CD4 counts in the range of 51-100. Also, 55 patients (55%) received antiretroviral therapy (ART), and 45 (45%) cases were ART naï􀇅ve. About 56% of patients had no opportunistic infections, and 37% had pulmonary tuberculosis. Three samples were positive in LFA, showing a prevalence of 3%, while only one of the culture samples was positive for Cryptococcus species. However, low CD4 count was found to be strongly correlated with positive serum cryptococcal antigenemia.

Conclusion: The present study reveals that cryptococcal antigenemia is a health problem, and that cryptococcal antigen screening and treatment policy recommended by WHO should be performed routinely for HIV patients registered in ART centres in the current setting, especially for those who are ART naï􀇅ve and have CD4 counts of ≤100 cells/mm3.

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Infection Epidemiology and Microbiology
Volume 8, Issue 1
February 2022
Pages 53-60