Prevalence of Cryptococcal Antigenemia and Lateral Flow Assay Accuracy in Severely Immunosuppressed AIDS Patients

This study aimed to estimate the prevalence of cryptococcal antigenemia detected by lateral flow assay (LFA) in AIDS patients and its accuracy in the diagnosis of cryptococcosis. Conducted at a university hospital in Brazil from March 2015 to July 2017, it included AIDS patients over 18 years old wi...

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Published inJournal of fungi (Basel) Vol. 10; no. 7; p. 490
Main Authors Negri, Adriana Carla Garcia, Nunes, Maína de Oliveira, Lima, Gláucia Moreira Espíndola, Venturini, James, de Oliveira, Sandra Maria do Valle Leone, Lazera, Márcia Dos Santos, Carvalho, Lídia Raquel de, Chang, Marilene Rodrigues, Tsujisaki, Rosianne Assis de Sousa, França, Adriana de Oliveira, Mendes, Rinaldo Poncio, Paniago, Anamaria Mello Miranda
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 01.07.2024
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Summary:This study aimed to estimate the prevalence of cryptococcal antigenemia detected by lateral flow assay (LFA) in AIDS patients and its accuracy in the diagnosis of cryptococcosis. Conducted at a university hospital in Brazil from March 2015 to July 2017, it included AIDS patients over 18 years old with a CD4+ count ≤ 200 cells/mm . Cryptococcal antigen (CrAg) detection using LFA and latex agglutination (LA), along with blood and urine cultures, were performed. The reference standard was the identification of spp. in clinical specimens through microbiological or histopathological examination. Among 230 patients, the prevalence of CrAg detected by LFA (CrAg LFA) was 13.0%. Factors associated with cryptococcal antigenemia included fever, vomiting, seizures, and a lack of antiretroviral therapy. The sensitivity and specificity of CrAg LFA were 83.9% and 98.0%, respectively. The positive predictive value (PPV) was 86.7%, the negative predictive value (NPV) was 97.5%, and overall accuracy was 96.1%. Cross-reactions were observed in patients with histoplasmosis and paracoccidioidmycosis, but not with aspergillosis or positive rheumatoid factor. The study concludes that the LFA is a useful tool for detecting cryptococcal antigenemia in severely immunocompromised AIDS patients due to its high NPV, specificity, and PPV.
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ISSN:2309-608X
2309-608X
DOI:10.3390/jof10070490