{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T06:41:40Z","timestamp":1696315300369},"reference-count":15,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,5,11]],"date-time":"2015-05-11T00:00:00Z","timestamp":1431302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006537","name":"Vanderbilt University","doi-asserted-by":"publisher","award":["R24 TW007988"],"award-info":[{"award-number":["R24 TW007988"]}],"id":[{"id":"10.13039\/100006537","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01 MH090326","R01 MH073445"],"award-info":[{"award-number":["R01 MH090326","R01 MH073445"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23 AI108293","R01 AI058736"],"award-info":[{"award-number":["K23 AI108293","R01 AI058736"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007301","name":"Harvard University Center for AIDS Research","doi-asserted-by":"publisher","award":["P30 AI060354"],"award-info":[{"award-number":["P30 AI060354"]}],"id":[{"id":"10.13039\/100007301","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K24 AR057827"],"award-info":[{"award-number":["K24 AR057827"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000097","name":"National Center for Research Resources","doi-asserted-by":"publisher","award":["UL1 RR 025758"],"award-info":[{"award-number":["UL1 RR 025758"]}],"id":[{"id":"10.13039\/100000097","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">W<\/jats:styled-content>orld <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>ealth <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>rganization (<jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>) recommends screening <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected people for cryptococcal antigens to identify cryptococcosis, a major cause of <jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content>\u2010related deaths. As the burden of cryptococcosis is unknown in <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>outh <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frica's <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>wa<jats:styled-content style=\"fixed-case\">Z<\/jats:styled-content>ulu\u2010<jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>atal province, we assessed the cryptococcal antigenuria prevalence among newly diagnosed <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected adults there.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cross\u2010sectional study of newly diagnosed <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected adults who received voluntary <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing in an out\u2010patient clinic. Participants provided a urine specimen in a sterile container, and we performed testing with a <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>\u2010endorsed rapid cryptococcal antigen lateral flow assay (<jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>mmy <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>nc., <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>orman, <jats:styled-content style=\"fixed-case\">OK<\/jats:styled-content>, <jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content>) per the manufacturer's specifications. We assessed cryptococcal antigenuria prevalence among participants with <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> counts\u2009&lt;\u2009200\u2009cells\/\u03bcL, and stratified results by <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> count categories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 432 participants, the mean (\u00b1\u2009standard deviation) age was 36.1\u2009\u00b1\u20099.9 years and 172 (40%) were female. The overall estimated prevalence of cryptococcal antigenuria was 9.0% [95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 6.5\u201312.1%]. <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> counts were available for 319 participants (74%); the median <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> count was 75\u2009cells\/\u03bcL [interquartile range (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>) 34\u2013129\u2009cells\/\u03bcL]. Participants with a negative cryptococcal antigenuria screening test had a median <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> count of 79\u2009cells\/\u03bcL (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 36\u2013129\u2009cells\/\u03bcL), while participants with a positive cryptococcal test had a median <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> count of 41\u2009cells\/\u03bcL (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 10\u2013112\u2009cells\/\u03bcL). The estimated prevalence of cryptococcal antigenuria among participants with <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> counts &lt;\u200950\u2009cells\/\u03bcL was 12.5% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 7.0\u201320.1%), which was significantly higher than that among participants with <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> counts of 50\u2013200\u2009cells\/\u03bcL (4.8%; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.3\u20138.7%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nearly 1 in 10 newly diagnosed <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected adults with <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> counts &lt;\u2009200\u2009cells\/\u03bcL in <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>wa<jats:styled-content style=\"fixed-case\">Z<\/jats:styled-content>ulu\u2010Natal had evidence of cryptococcal antigenuria. Point\u2010of\u2010care <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> count testing and cryptococcal antigen screening may rapidly identify cryptococcosis at the time of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12263","type":"journal-article","created":{"date-parts":[[2015,5,11]],"date-time":"2015-05-11T07:57:26Z","timestamp":1431331046000},"page":"640-644","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence of cryptococcal antigenuria at initial <scp>HIV<\/scp> diagnosis in <scp>K<\/scp>wa<scp>Z<\/scp>ulu\u2010<scp>N<\/scp>atal"],"prefix":"10.1111","volume":"16","author":[{"given":"PK","family":"Drain","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JM","family":"Kleene","sequence":"additional","affiliation":[{"name":"Stony Brook School of Medicine  Stony Brook 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