Cryptococcosis primary prevention
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
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Overview
It is recommended that patients with CD4 counts ≤ 100 cells/μl should have routine cryptococcal antigen screenings and patients with a positive result should be offered preemptive anti-fungal therapy.
Primary Prevention
- Take the lowest doses of corticosteroid medications possible.
- Practice safe sex to reduce the risk of getting HIV and other infections associated with a weakened immune system.
- Cryptococcal meningitis commonly affects patients with a CD4 count of ≤ 100 cells/μl. It is a major cause of mortality and morbidity in HIV positive individuals. It is recommended that patients with CD4 counts ≤ 100 cells/μl should have routine cryptococcal antigen screenings. Patients with a positive result should be offered preemptive anti-fungal therapy.[1][2]
- One strategy to prevent cryptococcal meningitis deaths is to treat all HIV/AIDS patients with a CD4 <100 with low-dose fluconazole 200 mg daily. This has shown to decrease the number of cryptococcal infections, but has not consistently decreased rates of death from cryptococcal disease.[3]
References
- ↑ Cassim N, Schnippel K, Coetzee LM, Glencross DK (2017). "Establishing a cost-per-result of laboratory-based, reflex Cryptococcal antigenaemia screening (CrAg) in HIV+ patients with CD4 counts less than 100 cells/μl using a Lateral Flow Assay (LFA) at a typical busy CD4 laboratory in South Africa". PLoS One. 12 (2): e0171675. doi:10.1371/journal.pone.0171675. PMID 28166254.
- ↑ Greene G, Sriruttan C, Le T, Chiller T, Govender NP (2017). "Looking for fungi in all the right places: screening for cryptococcal disease and other AIDS-related mycoses among patients with advanced HIV disease". Curr Opin HIV AIDS. 12 (2): 139–147. doi:10.1097/COH.0000000000000347. PMID 28134711.
- ↑ "www.cdc.gov" (PDF).