{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T12:49:23Z","timestamp":1749559763323,"version":"3.37.3"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI118511"],"award-info":[{"award-number":["R01AI118511"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>There is scarce information about HIV-related cryptococcosis in the Brazilian Amazon basin where laboratory infrastructure is limited. The serum cryptococcal antigen (CrAg) lateral flow assay (LFA) has simplified diagnosis of cryptococcosis and is recommended for screening in advanced HIV disease. We evaluated the prevalence of cryptococcal antigenemia using finger-prick CrAg LFA in the Brazilian Amazon basin. We enrolled a prospective cohort of outpatients and hospitalized individuals with advanced HIV disease at two centers in Santar\u00e9m Municipality, Northern Brazil. All individuals were\u00a0&amp;gt;\u00a018 years old with advanced HIV disease, regardless of antiretroviral therapy (ART) status and with no prior or current history of confirmed cryptococcal meningitis. We tested CrAg LFA on finger-prick whole blood using an exact volume transfer pipette. From August 2018 to October 2019, 104 individuals were enrolled (outpatients 62 [60%] and hospitalized 42 [40%]). Median age was 38 years (interquartile range [IQR] 30\u201346), and 84 (81%) were male. Sixty-five (63%) individuals were ART-na\u00efve. Prevalence of finger-prick CrAg LFA-positive was 10.6%; 95% CI, 5.4 to 18.1%. Prevalence of finger-prick CrAg LFA-positive among individuals without neurological symptoms was 6.0%; 95% CI, 1.7\u201314.6%. The number needed to test to detect one CrAg-positive individual was 9.4 persons (95% CI, 5.5\u201318.5). Prevalence of cryptococcal antigenemia using finger-prick whole blood CrAg LFA was high. Point-of-care approach was important for the diagnosis and screening of cryptococcosis in resource-limited settings. Screening and preemptive therapy strategy should be urgently implemented in individuals with advanced HIV disease in the Brazilian Amazon basin.<\/jats:p>","DOI":"10.1093\/mmy\/myab021","type":"journal-article","created":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T16:10:53Z","timestamp":1616602253000},"page":"909-915","source":"Crossref","is-referenced-by-count":5,"title":["High prevalence of Cryptococcal antigenemia using a finger-prick lateral flow assay in individuals with advanced HIV disease in Santar\u00e9m Municipality, Brazilian Amazon Basin"],"prefix":"10.1093","volume":"59","author":[{"given":"Jo\u00e3o Guilherme Pontes Lima","family":"Assy","sequence":"first","affiliation":[{"name":"Centro de Testagem e Aconselhamento\/Servi\u00e7o de Assist\u00eancia Especializada (CTA\/SAE) de Santar\u00e9m, Santar\u00e9m 68005-310, Par\u00e1, Brazil"},{"name":"Hospital Municipal de Santar\u00e9m, Santar\u00e9m 68005-110, Par\u00e1, Brazil"},{"name":"N\u00facleo de Medicina Tropical, Departamento de Mol\u00e9stias Infecciosas e Parasit\u00e1rias, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato do Carmo","family":"Said","sequence":"additional","affiliation":[{"name":"Centro de Testagem e Aconselhamento\/Servi\u00e7o de Assist\u00eancia Especializada (CTA\/SAE) de Santar\u00e9m, Santar\u00e9m 68005-310, Par\u00e1, Brazil"},{"name":"Hospital Municipal de Santar\u00e9m, Santar\u00e9m 68005-110, Par\u00e1, Brazil"},{"name":"N\u00facleo de Medicina Tropical, Departamento de Mol\u00e9stias Infecciosas e Parasit\u00e1rias, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia Campos","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Centro de Testagem e Aconselhamento\/Servi\u00e7o de Assist\u00eancia Especializada (CTA\/SAE) de Santar\u00e9m, Santar\u00e9m 68005-310, Par\u00e1, Brazil"},{"name":"Hospital Municipal de Santar\u00e9m, Santar\u00e9m 68005-110, Par\u00e1, Brazil"},{"name":"N\u00facleo de Medicina Tropical, Departamento de Mol\u00e9stias Infecciosas e Parasit\u00e1rias, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alisson dos Santos","family":"Brand\u00e3o","sequence":"additional","affiliation":[{"name":"Centro de Testagem e Aconselhamento\/Servi\u00e7o de Assist\u00eancia Especializada (CTA\/SAE) de Santar\u00e9m, Santar\u00e9m 68005-310, Par\u00e1, Brazil"},{"name":"Hospital Municipal de Santar\u00e9m, Santar\u00e9m 68005-110, Par\u00e1, Brazil"},{"name":"N\u00facleo de Medicina Tropical, Departamento de Mol\u00e9stias Infecciosas e Parasit\u00e1rias, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R","family":"Boulware","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota 55455, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Oscar de Siqueira","family":"Fran\u00e7a","sequence":"additional","affiliation":[{"name":"N\u00facleo de Medicina Tropical, Departamento de Mol\u00e9stias Infecciosas e Parasit\u00e1rias, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"},{"name":"Laboratory of Medical Investigation in Immunology, Unit 48, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7830-8716","authenticated-orcid":false,"given":"Jos\u00e9 Ernesto","family":"Vidal","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Cl\u00ednica de Mol\u00e9stias Infecciosas e Parasit\u00e1rias, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"},{"name":"Department of Neurology, Instituto de Infectologia Em\u00edlio Ribas, S\u00e3o Paulo 01246-900, Brazil"},{"name":"Laboratory of Medical Investigation, Unit 49, Hospital das Clinicas, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"volume-title":"Guidelines for The Diagnosis, Prevention and Management of Cryptococcal Disease in HIV-Infected Adults, Adolescents and Children: Supplement to the 2016 Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection","year":"2018","author":"World Health 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