Background: There is a high burden of
HIV-related cryptococcal meningitis in Sub-Saharan Africa and it is a leading
cause of morbidity and early mortality among severely immunocompromised
patients. Objectives of the Study: This study was carried out to determine the
prevalence of cryptococcal antigen (CrAg) and the relationship of positivity to
CD4+ve T cell counts and WHO clinical stage among severely immunocompromised
treatment naive adult HIV-infected Nigerian patients. Methods: This was a
hospital based cross sectional and prospective study carried out among newly
diagnosed and confirmed HIV infected patients. Bio data of consenting
consecutive subjects was collected by the attending physician using structured
questionnaire. Rapid point of care lateral flow assay kits (IMMY, USA) was used
to screen plasma samples from subjects strictly following manufacturer’s
instructions. Data were analysed with statistical package for social sciences
(spss 15.0) software. Results were presented in simple tables with frequencies
and percentages while statistical significance was taken to be p value ≤ 0.05.
Results: Of 432 subjects, there were 184 (42.6%) males and 248 (57.4%) females
in the study. The median CD4 count of the subjects was 74 (range 6 - 1264)
cells/ul. Seven (1.6%) of the subjects were positive for cryptococcal antigen
(CrAg) and all were females (100%). Six (85.7%) of CrAg positives had CD4+ T
cell count less than 100 cells, while 1 (14.3%) had count above 200cells/ul.
The WHO clinical stage of studied patients was; stage I 163 (37.7%), stage II
132 (30.6%) stage III 95 (22.0%) and stage IV 42 (9.7%). Among the CrAg
positive subjects, 3 (42.9%) were in WHO clinical stage l while 4 (57.1%) were
in stage II disease. Conclusion: The observed overall prevalence of CrAg
positivity among studied patients was low but occurred most frequently among
the severely immunocompromised subjects. Advancement in WHO clinical stage was
not a predicting risk factor for cryptococcal antigenaemia in studied adult HIV
infected patients.
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