The value of cryptococcal serum antigen screening among HIV-positive/AIDS patients in Kinshasa, Zaire

Abstract

Cryptococcal meningitis is a frequently observed opportunistic infection in AIDS patients in Zaire and other countries in Central Africa. The prognosis in those patients is very poor because of the advanced stage of their cryptococcal disease at presentation. To improve the prognosis of cryptococcal meningitis in HIV-infected patients through earlier diagnosis, a routine serum cryptococcal antigen screening was performed on 450 HIV-positive/AIDS patients seen at the Cliniques Universitaires de Kinshasa between 1 January 1988 and 31 August 1988. Cryptococcal antigen was detected in the sera of 55 (12.2%) of them. Cerebrospinal fluid was obtained from 44 of these 55 patients and the presence of Cryptococcus neoformans was demonstrated by direct microscopy and culture in 29 (66%) of them.A routine serum cryptococcal antigen screening of 450 human immunodeficiency virus (HIV)-positive/acquired immunodeficiency syndrome (AIDS) patients at the Cliniques Universitaires de Kinshasa, Zaire, revealed that cryptococcal antigen was present in the sera of 55 (12.2%) of them. Health professionals collected cerebrospinal fluid of 44 patients from the positive serum group. The fungus Cryptococcus neoformans was identified by direct microscopy and culture in 29 (66%) of them. 6.6% of the originally screened HIV-positive/AIDS patients, therefore, had cryptococcal meningitis which is an opportunistic infection in these individuals. Serum screening for cryptococcal antigens could improve the prognosis of cryptococcal meningitis in HIV-infected patients by introducing an appropriate antifungal treatment at an early stage.