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J. Fungi 2016, 2(2), 14; doi:10.3390/jof2020014

Preemptive Therapy for Cryptococcal Meningitis: A Valid Strategy for Latin America?

Department of Neurology; Emilio Ribas Institute of Infectious Diseases; Av Doutor Arnaldo 165, Cerqueira César, São Paulo, CEP 05411-000, Brazil
Academic Editor: Arnaldo Lopes Colombo
Received: 7 April 2016 / Revised: 11 May 2016 / Accepted: 16 May 2016 / Published: 23 May 2016
(This article belongs to the Special Issue Fungal Infections in the Developing World)
View Full-Text   |   Download PDF [171 KB, uploaded 23 May 2016]

Abstract

AIDS-related cryptococcal meningitis continues to cause a substantial burden of death in low and middle income countries. Better diagnostics allow detection of cryptococcosis in the asymptomatic phase and using these technologies to screen at-risk persons would likely reduce mortality. The World Health Organization recommends cryptococcal antigen screening among populations with a prevalence of cryptococcal antigenaemia (CRAG) > 3%. There is scarce data about CRAG prevalence in Latin America. Four studies (only one published as a full text) showed asymptomatic CRAG prevalence between 2.7% and 6.2% in several sub-sets of HIV-infected patients. The CRAG lateral flow assay (LFA) has several advantages over other techniques for actual implementation of a screening program. Although more studies are necessary to confirm available data, implementation of the CRAG screening strategy seems to be opportune in Latin America. View Full-Text
Keywords: cryptococcal antigen; cryptococcal meningitis; screening; preemptive therapy cryptococcal antigen; cryptococcal meningitis; screening; preemptive therapy
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Vidal, J.E. Preemptive Therapy for Cryptococcal Meningitis: A Valid Strategy for Latin America? J. Fungi 2016, 2, 14.

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