{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T16:13:24Z","timestamp":1794327204164,"version":"4.9.0"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T00:00:00Z","timestamp":1539302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Shanghai Municipal Commission of Health and Family Planning","award":["20164Y0015"],"award-info":[{"award-number":["20164Y0015"]}]},{"name":"Shanghai Municipal Commission of Health and Family Planning","award":["15GWZK0103"],"award-info":[{"award-number":["15GWZK0103"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim was to determine the effectiveness of the serum cryptococcal antigen (CrAg) test in the diagnosis of concurrent cryptococcal meningitis (<jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>) and as a predictor of mortality in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective study, all <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected patients admitted to Shanghai Public Health Clinical Center from 1 January 2014 to 31 August 2016 were screened for serum CrAg using the latex agglutination test. Serum CrAg\u2010positive patients underwent lumbar puncture to confirm <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> prior to the initiation of appropriate antifungal therapy and were followed up for at least 6\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and four (7.1%) of the total of 1474 <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected patients screened were serum CrAg\u2010positive. <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> was diagnosed in the majority of serum CrAg\u2010positive patients (71.3%; 67 of 94) and was confirmed in all (46 of 46) of the patients with headache or coma and in 43.8% (21 of 48) of patients without neurological symptoms. CrAg titres \u2265\u00a01:1024 showed a sensitivity of 82.5% and a specificity of 86.7% for the diagnosis of concurrent <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001). The positive predictive value for <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> in this population was 94.3%. A total of 13 serum CrAg\u2010positive patients [13.8%; 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI)<\/jats:styled-content> 7.5\u201322.4%] died (11 as a result of <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> and two others as a result of bacterial pneumonia) despite early antifungal treatment initiation. Serum CrAg titres \u2265\u00a01:1024 predicted all\u2010cause mortality (hazard ratio\u00a03.69; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Serum CrAg titres \u2265\u00a01:1024 not only were associated with concurrent <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> but also predicted mortality. <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected patients with a positive serum CrAg test during screening should receive lumbar punctures regardless of symptoms to rule out <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> and patients with serum CrAg titres \u2265\u00a01:1024 should be offered immediate care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12679","type":"journal-article","created":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T09:09:40Z","timestamp":1539335380000},"page":"69-73","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Serum cryptococcal antigen titre as a diagnostic tool and a predictor of mortality in <scp>HIV<\/scp>\u2010infected patients with cryptococcal meningitis"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3850-4875","authenticated-orcid":false,"given":"J","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Shanghai Public Health Clinical Center Shanghai China"},{"name":"Chronic Viral Illness Service McGill University Health Centre Montreal QC Canada"},{"name":"Research Institute of the McGill University Health Centre Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Shanghai Public Health Clinical Center Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Shanghai Public Health Clinical Center Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Shanghai Public Health Clinical Center Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Shanghai Public Health Clinical Center Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Shanghai Public Health Clinical Center Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Mehraj","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service McGill University Health Centre Montreal QC Canada"},{"name":"Research Institute of the McGill University Health Centre Montreal QC Canada"},{"name":"CR\u2010CHUM Universit\u00e9 de Montr\u00e9al Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JP","family":"Routy","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service McGill University Health Centre Montreal QC Canada"},{"name":"Research Institute of the McGill University Health Centre Montreal QC Canada"},{"name":"Division of Hematology McGill University Health Centre Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Shanghai Public Health Clinical Center Shanghai China"},{"name":"Department of Internal Medicine Shanghai Medical College Fudan University Shanghai China"},{"name":"Department of Infectious Diseases Huashan Hospital Affiliated to Fudan University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30243-8"},{"key":"e_1_2_6_3_1","first-page":"1122","article-title":"Long term mortality and disability in Cryptococcal Meningitis: a systematic literature review","volume":"66","author":"Pasquier E","year":"2017","journal-title":"Clin Infect Dis"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60164-7"},{"key":"e_1_2_6_5_1","volume-title":"Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection. 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