Cryptococcal Antigen Screening Evaluated Among People Living with HIV
|
By LabMedica International staff writers Posted on 03 Jun 2021 |
|
Image: The CrAg LFA (lateral flow assay) can detect cryptococcal antigens in the blood of asymptomatic patients prior to development of cryptococcal meningitis enabling pre-emptive treatment of CrAg positive patients (Photo courtesy of Immy Diagnostics)
Cryptococcosis is a potentially fatal fungal disease caused by a few species of Cryptococcus (most often Cryptococcus neoformans or Cryptococcus gattii). Cryptococcosis is believed to be acquired by inhalation of the infectious propagule from the environment.
Most people in the USA who develop cryptococcal infections are HIV-positive. However, occasionally persons with no apparent immune system problems develop cryptococcosis. Cryptococcosis remains a leading cause of meningitis and mortality among people living with HIV (PLHIV) worldwide.
An international team of scientists led by the University of Washington (Seattle, WA, USA) evaluated laboratory-based cryptococcal antigen (CrAg) reflex testing and a clinic-based point-of-care (POC) CrAg screening intervention for preventing meningitis and mortality among PLHIV in South Africa. The team included 3,105 (39.4%) of 7,877 people screened were HIV-positive, of whom 908 had CD4 ≤200 cells/mm3 and were included in the analyses. The laboratory and clinical teams performed serum CrAg by enzyme immunoassay and lateral flow assay (Immy Diagnostics, Norman, OK, USA).
The investigators reported that Lab reflex and clinic-based testing significantly increased CrAg screening and diagnosis of CrAg-positive PLHIV. As compared to clinician-directed testing, clinic-based CrAg testing increased the number of PLHIV diagnosed with cryptococcal meningitis (4.5% compared to 1.5%), initiation of fluconazole pre-emptive therapy (7.2% compared to 2.5%), and initiation of ART (96.8% compared to 91.3%). Comparing clinic-based testing to lab reflex testing, there was no significant difference in the cumulative incidence of cryptococcal meningitis (4.5% compared to 4.1%) or mortality (8.1% compared to 9.9%).
The authors concluded that Lab reflex and clinic-based CrAg testing facilitated diagnosis of HIV-associated cryptococcosis and fluconazole initiation, but did not reduce cryptococcal meningitis or mortality. In this non-randomized cohort, clinical outcomes were similar between lab reflex testing and clinic-based point-of-care CrAg testing. The study was published on May 10, 2021 in the Journal of Acquired Immune Deficiency Syndromes.
Related Links:
University of Washington
Immy Diagnostics
Most people in the USA who develop cryptococcal infections are HIV-positive. However, occasionally persons with no apparent immune system problems develop cryptococcosis. Cryptococcosis remains a leading cause of meningitis and mortality among people living with HIV (PLHIV) worldwide.
An international team of scientists led by the University of Washington (Seattle, WA, USA) evaluated laboratory-based cryptococcal antigen (CrAg) reflex testing and a clinic-based point-of-care (POC) CrAg screening intervention for preventing meningitis and mortality among PLHIV in South Africa. The team included 3,105 (39.4%) of 7,877 people screened were HIV-positive, of whom 908 had CD4 ≤200 cells/mm3 and were included in the analyses. The laboratory and clinical teams performed serum CrAg by enzyme immunoassay and lateral flow assay (Immy Diagnostics, Norman, OK, USA).
The investigators reported that Lab reflex and clinic-based testing significantly increased CrAg screening and diagnosis of CrAg-positive PLHIV. As compared to clinician-directed testing, clinic-based CrAg testing increased the number of PLHIV diagnosed with cryptococcal meningitis (4.5% compared to 1.5%), initiation of fluconazole pre-emptive therapy (7.2% compared to 2.5%), and initiation of ART (96.8% compared to 91.3%). Comparing clinic-based testing to lab reflex testing, there was no significant difference in the cumulative incidence of cryptococcal meningitis (4.5% compared to 4.1%) or mortality (8.1% compared to 9.9%).
The authors concluded that Lab reflex and clinic-based CrAg testing facilitated diagnosis of HIV-associated cryptococcosis and fluconazole initiation, but did not reduce cryptococcal meningitis or mortality. In this non-randomized cohort, clinical outcomes were similar between lab reflex testing and clinic-based point-of-care CrAg testing. The study was published on May 10, 2021 in the Journal of Acquired Immune Deficiency Syndromes.
Related Links:
University of Washington
Immy Diagnostics
Gold Member
Antipsychotic TDM Assays
Saladax Antipsychotic Assays
New
Gold Member
Collection and Transport System
PurSafe Plus®
New
8-Channel Pipette
SAPPHIRE 20–300 µL
Latest Microbiology News
- Microfluidic Platform Assesses Neutrophil Function in Sepsis Patients
- New Diagnostic Method Confirms Sepsis Infections Earlier
- New Markers Could Predict Risk of Severe Chlamydia Infection
- Portable Spectroscopy Rapidly and Noninvasively Detects Bacterial Species in Vaginal Fluid
- CRISPR-Based Saliva Test Detects Tuberculosis Directly from Sputum
- Urine-Based Assay Diagnoses Common Lung Infection in Immunocompromised People
- Saliva Test Detects Implant-Related Microbial Risks
- New Platform Leverages AI and Quantum Computing to Predict Salmonella Antimicrobial Resistance
- Early Detection of Gut Microbiota Metabolite Linked to Atherosclerosis Could Revolutionize Diagnosis
- Viral Load Tests Can Help Predict Mpox Severity
- Gut Microbiota Analysis Enables Early and Non-Invasive Detection of Gestational Diabetes
- Credit Card-Sized Test Boosts TB Detection in HIV Hotspots
- Fecal Metabolite Profiling Predicts Mortality in Critically Ill Patients
- Portable Molecular POC System Rules Out UTIs in Just 35 Minutes
- POC Lateral Flow Test Detects Deadly Fungal Infection Faster Than Existing Techniques
- Rapid Diagnostic Test Slashes Sepsis Mortality by 39%
Channels
Clinical Chemistry
view channel
Gold Nanoparticles to Improve Accuracy of Ovarian Cancer Diagnosis
Ovarian cancer is considered one of the deadliest cancers, in part because it rarely shows clear symptoms in its early stages, and diagnosis is often complex. Current approaches make it difficult to accurately... Read more
Simultaneous Cell Isolation Technology Improves Cancer Diagnostic Accuracy
Accurate cancer diagnosis remains a challenge, as liquid biopsy techniques often fail to capture the complexity of tumor biology. Traditional systems for isolating circulating tumor cells (CTCs) vary in... Read more
Molecular Diagnostics
view channel
Brain Inflammation Biomarker Detects Alzheimer’s Years Before Symptoms Appear
Alzheimer’s disease affects millions globally, but patients are often diagnosed only after memory loss and other symptoms appear, when brain damage is already extensive. Detecting the disease much earlier... Read more
First-of-Its-Kind Blood Test Detects Over 50 Cancer Types
Many cancers lack routine screening, so patients are often diagnosed only after tumors grow and spread, when options are limited. A faster, less invasive approach that broadens early detection could shift... Read more
Routine Blood Draws Could Detect Epigenetic Biomarkers for Predicting Cardiovascular Disease Risk
Cardiovascular disease is a leading cause of death worldwide, yet predicting individual risk remains a persistent challenge. Traditional risk factors, while useful, do not fully capture biological changes... Read more
Hematology
view channel
Pioneering Model Measures Radiation Exposure in Blood for Precise Cancer Treatments
Scientists have long focused on protecting organs near tumors during radiotherapy, but blood — a vital, circulating tissue — has largely been excluded from dose calculations. Each blood cell passing through... Read more
Platelets Could Improve Early and Minimally Invasive Detection of Cancer
Platelets are widely recognized for their role in blood clotting and scab formation, but they also play a crucial role in immune defense by detecting pathogens and recruiting immune cells.... Read more
Portable and Disposable Device Obtains Platelet-Rich Plasma Without Complex Equipment
Platelet-rich plasma (PRP) plays a crucial role in regenerative medicine due to its ability to accelerate healing and repair tissue. However, obtaining PRP traditionally requires expensive centrifugation... Read more
Microbiology
view channel
Microfluidic Platform Assesses Neutrophil Function in Sepsis Patients
Sepsis arises from infection and immune dysregulation, with neutrophils playing a central role in its progression. However, current clinical tools are unable to both isolate these cells and assess their... Read more
New Diagnostic Method Confirms Sepsis Infections Earlier
Sepsis remains one of the most dangerous medical emergencies, often progressing rapidly and becoming fatal without timely intervention. Each hour of delayed treatment in septic shock reduces patient survival... Read more
New Markers Could Predict Risk of Severe Chlamydia Infection
Chlamydia trachomatis is a common sexually transmitted infection that can cause pelvic inflammatory disease, infertility, and other reproductive complications when it spreads to the upper genital tract.... Read more
Portable Spectroscopy Rapidly and Noninvasively Detects Bacterial Species in Vaginal Fluid
Vaginal health depends on maintaining a balanced microbiome, particularly certain Lactobacillus species. Disruption of this balance, known as dysbiosis, can increase risks of infection, pregnancy complications,... Read morePathology
view channel
Accurate Pathological Analysis Improves Treatment Outcomes for Adult Fibrosarcoma
Adult fibrosarcoma is a rare and highly aggressive malignancy that develops in connective tissue and often affects the limbs, trunk, or head and neck region. Diagnosis is complex because tumors can mimic... Read more
Clinicopathologic Study Supports Exclusion of Cervical Serous Carcinoma from WHO Classification
High-grade serous carcinoma is a rare diagnosis in cervical biopsies and can be difficult to distinguish from other tumor types. Cervical serous carcinoma is no longer recognized as a primary cervical... Read more
Technology
view channel
Coral-Inspired Capsule Samples Hidden Bacteria from Small Intestine
The gut microbiome has been linked to conditions ranging from immune disorders to mental health, yet conventional stool tests often fail to capture bacterial populations in the small intestine.... Read more
Rapid Diagnostic Technology Utilizes Breath Samples to Detect Lower Respiratory Tract Infections
Respiratory tract infections (LRTIs) are leading causes of illness and death worldwide, particularly among vulnerable populations such as the elderly, young children, and those with compromised immune systems.... Read more
Industry
view channel
Werfen and VolitionRx Partner to Advance Diagnostic Testing for Antiphospholipid Syndrome
Antiphospholipid syndrome (APS) is a rare autoimmune disorder that causes the immune system to produce abnormal antibodies, making the blood “stickier” than normal. This condition increases the risk of... Read more
