Please use this identifier to cite or link to this item: https://etd.cput.ac.za/handle/20.500.11838/3491
Title: Evaluation of new semi-quantitative cryptococcal antigen Immy (immunochromatographic) SQ (semi-quantitative) and Biosynex tests in plasma for detection of subclinical cryptococcal meningitis in HIV positive patients with CD4 <100
Authors: Blasich, Nozuko Precious 
Keywords: Cryptococcus;HIV (Viruses);HIV infections;Meningitis;Medical screening
Issue Date: 2021
Publisher: Cape Peninsula University of Technology
Abstract: Introduction: Blood cryptococcal antigen (CrAg) titres >160 are associated with concurrent subclinical cryptococcal meningitis (CM). When lumbar puncture (LP) is not immediately available in a CrAg screening programme, semi-quantitative CrAg assays may provide risk stratification for CM. Materials and methods: Two semi-quantitative assays (SQ [Immuno-Mycologics, Norman, OK, USA] and CryptoPS [Biosynex, Strasbourg, France]) were evaluated against a qualitative lateral flow assay (LFA) using 194 plasma samples from a cohort of HIV-seropositive individuals with CD4 counts <100 cells/μL. We compared SQ and CryptoPS results to titres for LFA-positive samples. Among patients with LP, we examined the association between semi-quantitative CrAg results and CM. We used a Cox proportional hazards model to determine the association between SQ score and mortality. Results: Of 194 participants, 60 (31%) had positive LFA results, of whom 41 (68%) had a titre of ≤160 and 19 (32%) a titre >160. Fifty individuals with antigenaemia had an LP; a clinically-useful SQ score that identified all ten cases of subclinical CM was ≥3 (100% sensitivity, 55% specificity). Patients with an SQ score of 3 or 4 also had a 2.2-fold increased adjusted hazards of 6-month mortality (95% CI, 0.79-6.34; p=0.13) versus those with score of <3. Nine of ten patients with subclinical CM had a strong-positive CryptoPS result versus 10/40 without subclinical CM (p<0.001). Conclusions: Semi-quantitative assays offered a sensitive though not specific means of gauging the risk of concurrent CM in this patient population.
Description: Thesis (MSc (Biomedical Technology))--Cape Peninsula University of Technology, 2021
URI: http://hdl.handle.net/20.500.11838/3491
DOI: https://doi.org/10.25381/cput.19575790.v1
Appears in Collections:Biomedical Technology - Masters Degrees

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