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 <100Untitled Item

CPUT/HW-REC 2019/H28. MYCOLOGY DATA SET

We compared SQ and CryptoPS results to titers 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. Of

194 participants, 60 (31%) had positive LFA results, of whom 41 (68%) had a titer of ≤160 and 19 (32%) a

titer >160. Fifty individuals with antigenemia 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). Semi-quantitative assays offered a sensitive though not specific means

of gauging the risk of concurrent CM in this patient population.