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Highly sensitive assays can detect CrAg in blood, and screening people with HIV with low CD4 counts, followed by preemptive antifungal treatment, is recommended and widely implemented as part of a global strategy to prevent CM and end cryptococcal-related deaths. Cryptococcal antigenemia encompasses a spectrum of conditions from preclinical asymptomatic infection (cerebrospinal fluid [CSF] CrAg-negative) through subclinical (CSF CrAg-positive without overt meningism) to clinical symptomatic cryptococcal disease, usually manifesting as CM. In this review, we summarize current understanding of the pathophysiology, risk factors for, and clinical implications of cryptococcal antigenemia within this spectrum. We also provide an update on global prevalence, recommended screening and treatment strategies, and future considerations for improving outcomes among patients with cryptococcal antigenemia.<\/jats:p>","DOI":"10.1093\/cid\/ciac675","type":"journal-article","created":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T11:17:23Z","timestamp":1660994243000},"page":"764-770","source":"Crossref","is-referenced-by-count":40,"title":["Cryptococcal Antigenemia in Advanced Human Immunodeficiency Virus Disease: Pathophysiology, Epidemiology, and Clinical Implications"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3193-4888","authenticated-orcid":false,"given":"Rachel M","family":"Wake","sequence":"first","affiliation":[{"name":"Institute for Infection and Immunity, St George\u2019s University of London , London , United Kingdom"},{"name":"Clinical Academic Group in Infection and Immunity, St George\u2019s University Hospitals National Health Service Foundation Trust , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00edle F","family":"Molloy","sequence":"additional","affiliation":[{"name":"Institute for Infection and Immunity, St George\u2019s University of London , London , United Kingdom"},{"name":"Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph N","family":"Jarvis","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine , London , United Kingdom"},{"name":"Botswana Harvard AIDS Institute Partnership , Gaborone , Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas S","family":"Harrison","sequence":"additional","affiliation":[{"name":"Institute for Infection and Immunity, St George\u2019s University of London , London , United Kingdom"},{"name":"Clinical Academic Group in Infection and Immunity, St George\u2019s University Hospitals National Health Service Foundation Trust , London , United Kingdom"},{"name":"MRC Centre for Medical Mycology, University of Exeter , Exeter , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelesh P","family":"Govender","sequence":"additional","affiliation":[{"name":"Institute for Infection and Immunity, St George\u2019s University of London , London , United Kingdom"},{"name":"Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"},{"name":"MRC Centre for Medical Mycology, University of Exeter , Exeter , United Kingdom"},{"name":"Division of the National Health Laboratory Service, Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases , Johannesburg , South Africa"},{"name":"Division of Medical Microbiology, University of Cape Town , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"key":"2023021818294499600_","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/S1473-3099(17)30243-8","article-title":"Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis","volume":"17","author":"Rajasingham","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2023021818294499600_","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1086\/597262","article-title":"Screening for cryptococcal antigenemia in patients accessing an antiretroviral treatment program in South Africa","volume":"48","author":"Jarvis","year":"2009","journal-title":"Clin Infect Dis"},{"key":"2023021818294499600_","volume-title":"Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach [Internet]","author":"World Health Organization","year":"2021"},{"key":"2023021818294499600_","volume-title":"Rapid Advice. 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