Cryptococcosis in HIV – Infected Hospitalized Patients in Latvia

Main Article Content

Sangirejeva Anastasija
Azina Inga
Rozentale Baiba

Abstract

Aims: To determine the prevalence of cryptococcal infection among HIV hospitalized patients, to evaluate clinical characteristics and outcomes in Latvia.

Study Design:  Cross-sectional study.

Place and Duration of Study: Riga Eastern Clinical University Hospital, Latvian Center of Infectology, between January 2014 and February 2017.

Methodology: We conducted the study reporting demographics, epidemiological (age, sex, clinical aspects, paraclinical results (cryptococcal antigen in cerebrospinal fluid, serum, urine, cryptococcal DNA, HIV RNA and lymphocyte T CD4+ count), treatment and outcome aspects. We analyze 69 patients (71% men, 29% women) with HIV infection and cryptococcosis.

Results: 69 cases of cryptococcosis were confirmed for 699 HIV infected hospitalized patients tested, giving a prevalence of 9.9%. 38% (n=26/69) of patients were with clinical signs of infection with the central nervous system involvement, 19% (13/69) patients had pulmonary involvement.

Other 43% (n=30/69) of patients had disseminated non-CNS disease (elevated serum cryptococcal Ag or DNA). Most patients had advanced HIV disease (Median lymphocyte T CD4+ count=48, 5 cells/uL, (1-1041), the average was 112, 9 cells/ uL (SD 184.98). 87% (n=59/68) of patients had lymphocyte T CD4+cell count < 200 cells/μL Only 25% (n=14) of the patients known to have HIV infection (n=56/69) were receiving antiretroviral therapy at the time of presentation. Overall mortality rate was 59% (n=41/69).

Conclusion: Prevalence of cryptococcal antigenemia was 9.9%, indicating that the prevalence  of cryptococcal infection among HIV patients in Latvia may be high enough to consider targeted screening.HIV positive patients have high mortality (35%) following cryptococcal infection which persists beyond their initial hospitalization. Follow-up studies of late mortality would be beneficial.

Keywords:
Cryptoccocal infection, cryptoccocal antigenemia, ; invasive fungal infection, HIV, AIDS

Article Details

How to Cite
Anastasija, S., Inga, A., & Baiba, R. (2019). Cryptococcosis in HIV – Infected Hospitalized Patients in Latvia. Journal of Scientific Research and Reports, 24(2), 1-10. https://doi.org/10.9734/jsrr/2019/v24i230149
Section
Short Research Article

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