{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T02:15:30Z","timestamp":1768529730833,"version":"3.49.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2016,11,4]],"date-time":"2016-11-04T00:00:00Z","timestamp":1478217600000},"content-version":"vor","delay-in-days":308,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Medical Education Partnership Initiative in Nigeria"},{"name":"Forgarty International Center, the Office of AIDS Research"},{"name":"National Genome Research Institute of the National Institutes of Health"},{"DOI":"10.13039\/100000102","name":"Health Resources and Service Administration","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Office of the U.S. Global AIDS Coordinator","award":["R24TW008878"],"award-info":[{"award-number":["R24TW008878"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background. \u2003Cryptococcal meningitis has a high mortality in human immunodeficiency virus (HIV)-infected persons in Africa. This is preventable with early screening and preemptive therapy. We evaluated the prevalence of cryptococcal disease by antigen testing, possible associated factors, and outcomes in HIV-infected patients being managed in a tertiary hospital in Lagos, Nigeria.<\/jats:p>\n               <jats:p>Methods. \u2003Sera were collected from 214 consenting HIV-infected participants with CD4+ counts &amp;lt;250 cells\/mm3, irrespective of their antiretroviral therapy (ART) status, between November 2014 and May 2015. A cryptococcal antigen (CrAg) lateral flow assay was used for testing. Pertinent clinical data were obtained from patients and their case notes.<\/jats:p>\n               <jats:p>Results. \u2003Of the 214 participants, females (124; 57.9%) outnumbered males. Mean age was 41.3 \u00b1 9.4 (standard deviation) years. The majority (204; 95.3%) were ART experienced. The median CD4+ cell count was 160 cells\/mm3 (interquartile range, 90\u2013210). The overall seroprevalence of cryptococcal antigenemia was 8.9% (19 of 214); 6 of 61 (9.8%) in those with CD4+ cell counts &amp;lt;100 cells\/mm3, 4 of 80 (5.0%) in the 100\u2013200 group, and 9 of 73 (12.3%) in 200\u2013250 cells\/mm3 group. Among ART-naive patients, 1 of 10 (10%) was CrAg positive. Twenty-seven of 214 (12.6%) had associated oral thrush. Potential baseline meningitis symptoms (3 of 214 [1.4%] experienced neck pain or stiffness and 21 of 214 [9.8%] experienced headache) were common in the study group, but the result was not statistically significant in relation to CrAg positivity. Two of 19 (10.5%) CrAg-positive patients died, 10 of 19 (52.6%) were lost to follow up, and 7 of 19 (36.8%) were alive. Empirical fluconazole was routinely given to those with low CD4 counts &amp;lt;100 cells\/mm3, which was unrelated to CrAg positivity (P = .018).<\/jats:p>\n               <jats:p>Conclusions. \u2003We report a prevalence of 8.9% cryptococcal antigenemia in a setting where first-line antifungals are not readily available. We recommend CrAg screening for HIV-infected patients, even for patients on ART.<\/jats:p>","DOI":"10.1093\/ofid\/ofw055","type":"journal-article","created":{"date-parts":[[2016,5,1]],"date-time":"2016-05-01T00:53:33Z","timestamp":1462064013000},"source":"Crossref","is-referenced-by-count":24,"title":["Cryptococcal Antigenemia in Nigerian Patients With Advanced Human Immunodeficiency Virus: Influence of Antiretroviral Therapy Adherence"],"prefix":"10.1093","volume":"3","author":[{"given":"Rita O.","family":"Oladele","sequence":"first","affiliation":[{"name":"The University of Manchester, United Kingdom"},{"name":"College of Medicine of University of Lagos"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alani S.","family":"Akanmu","sequence":"additional","affiliation":[{"name":"US President's Emergency Plan for AIDS Relief Clinic, Lagos University Teaching Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augustina O.","family":"Nwosu","sequence":"additional","affiliation":[{"name":"AIDS Prevention Initiative in Nigeria, Central Laboratory, College of Medicine of University of Lagos, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Folasade T.","family":"Ogunsola","sequence":"additional","affiliation":[{"name":"College of Medicine of University of Lagos"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malcolm D.","family":"Richardson","sequence":"additional","affiliation":[{"name":"The University of Manchester, United Kingdom"},{"name":"National Aspergillosis Centre and Mycology Reference Centre Manchester, University Hospital of South Manchester and Manchester Academic Health Science Centre, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Denning","sequence":"additional","affiliation":[{"name":"The University of Manchester, United Kingdom"},{"name":"National Aspergillosis Centre and Mycology Reference 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