Chinese Medical Journal (Dec 2020)

Asymptomatic cryptococcal antigenemia in HIV-infected patients: a review of recent studies

  • Xiao-Lei Xu,
  • Ting Zhao,
  • Vijay Harypursat,
  • Yan-Qiu Lu,
  • Yan Li,
  • Yao-Kai Chen,
  • Peng Lyu.

DOI
https://doi.org/10.1097/CM9.0000000000001134
Journal volume & issue
Vol. 133, no. 23
pp. 2859 – 2866

Abstract

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Abstract. The prevalence of asymptomatic cryptococcal antigenemia (ACA) in human immunodeficiency virus (HIV) infected individuals has been observed to be elevated. The prevalence of ACA ranges from 1.3% to 13%, with different rates of prevalence in various regions of the world. We reviewed studies conducted internationally, and also referred to two established expert consensus guideline documents published in China, and we have concluded that Chinese HIV-infected patients should undergo cryptococcal antigen screening when CD4+ T-cell counts fall below 200 cells/μL and that the recommended treatment regimen for these patients follow current World Health Organization guidelines, although it is likely that this recommendation may change in the future. Early screening and optimized preemptive treatment for ACA is likely to help decrease the incidence of cryptococcosis, and is lifesaving. Further studies are warranted to explore issues related to the optimal management of ACA.