Cryptococcal antigen among HIV1-infected individuals in north-central Nigeria

The potential for the invasion of the central nervous system by Cryptococcus species is underscored by the presence of this organism in the blood of immunocompromised individuals. Early adoption of sensitive methods for the diagnosis of Cryptococcus species will reduce the high morbidity and mortality associated with this disease. Regarding this, the aim of the present research was to detect cryptococcal antigen among HIV1- infected individuals in north-central Nigeria.

This prospective cross-sectional study was carried out on HIV-1 infected individuals accessing care at three health facilities in north-central Nigeria between November 2014 and March 2017. For the purpose of the study, blood samples were collected from 300 HIV1-infected individuals within the age group of 3-65 years. The CD4+ T-cell count was determined, and the samples were analyzed for cryptococcal antigenemia using the methods of lateral flow assay (LFA) and culture technique.

Cryptococcus antigen was detected in 19.67% (59/300) of the patients, and only 25.4% (15/59) of the LFA-positive samples showed Cryptococcus species growth on Sabouraud dextrose agar after 3 days. Furthermore, fungal growth was observed in one of the specimens, which was LFA negative. Additionally, 30 of the 59 LFA-positive patients had cryptococcal antigen in their serum with a CD4+ T-cell count of < 150 cells/mm3.

As the findings of the present study indicated, infection with Cryptococcus species is a problem among HIV-infected patients in the region under study. Therefore, all HIV patients, especially those with a CD4+ T-cell count of < 150 cells/mm3, referring to the HAART clinics in Nigeria, should be screened for cryptococcal antigen.