Objective: Cryptococcal meningitis is an important cause of morbidity and mortality in
HIV infected individuals. In the era of universal antiretroviral therapy, the incidence of immune reconstitution
inflammatory syndrome (IRIS) related cryptococcal meningitis has increased. Detection
of serum cryptococcal antigen in asymptomatic PLHIV (People Living With HIV) and preemptive
treatment with fluconazole can decrease the burden of cryptococcal disease. We conducted
this study to find the prevalence of asymptomatic cryptococcal antigenemia in India and its correlation
with mortality in PLHIV.
Method and Materials: This was a prospective observational study. HIV infected ART naïve patients
with age of ≥ 18 years who had CD4 counts ≤ 100 /μL were included and serum cryptococcal
antigen test was done. These patients were followed for six months to look for the development
of Cryptococcal meningitis and mortality.
Results: A total of 116 patients were analyzed. Asymptomatic cryptococcal antigenemia was detected
in 5.17% of patients and is correlated with increased risk of cryptococcal meningitis and mortality
on follow-up in PLHIV.
Conclusion: Serum cryptococcal antigen positivity is correlated with an increased risk of Cryptococcal
meningitis and mortality in PLHIV. We recommend the screening of asymptomatic PLHIV
with CD4 ≤ 100/μL for serum cryptococcal antigen, so that pre-emptive treatment can be initiated
to reduce morbidity and mortality.