Prevalence of Cryptococcal Antigenemia and Associated Factors among HIV/AIDS Patients at Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia.
Prevalence of Cryptococcal Antigenemia and Associated Factors among HIV/AIDS Patients at Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia.
复制标题
DOI：
10.1155/2021/8839238
复制
发表时间：
2021
影响因子：
3.4
通讯作者：
Adem Y
中科院分区：
文献类型：
--
作者：
Jemal M;Deress T;Belachew T;Adem Y
隐球菌病是最常见的机会性真菌感染。在住院的 HIV/AIDS 患者中经常观察到高发病率和死亡率，特别是 CD4 计数≤100 个细胞/μl 的患者。因此，本研究旨在确定艾滋病毒/艾滋病患者中隐球菌抗原血症的患病率及相关因素。 对 140 名 HIV/AIDS 患者进行了一项以医院为基础的横断面研究。对所有患者进行了隐球菌抗原测试以及病历和实验室登记簿审查。使用Remel隐球菌抗原检测试剂盒检测血清中的隐球菌抗原。从患者图表和实验室登记簿中提取与可能相关因素相关的数据。使用 SPSS 20 版对数据进行编码、输入和分析。进行逻辑回归分析以查看因变量和自变量之间的关联。 P值<0.05被认为具有统计学意义。最后，数据以文本、图形、表格的形式呈现。 140 名血清隐球菌抗原血症检测研究对象中，16 名（11.43%）血清隐球菌抗原呈阳性。其中，43.8%（7/16）为肺结核合并感染，31.2%（5/16）为肺外结核阳性，25%（4/16）为细菌性血流感染。此外，68.7% (11/16) 的 CD4 计数低于 100 个细胞/μl，18.7% (3/16) 的 CD4 计数为 100-150 个细胞/μl，50% (8/16) 为抗逆转录病毒治疗违约者，31.3% (5/16) 为初治者。在这项研究中，大多数（75%（12/16））血清隐球菌抗原阳性受试者处于临床 IV 期。在评估的相关因素中，结核病合并感染（AOR：0.04；95% CI [0.005–0.25]）和抗逆转录病毒治疗状态（AOR：0.02；95% CI [0.001–0.5]）是增强血清隐球菌抗原血症的显着相关因素。 在这项研究中，住院的艾滋病毒/艾滋病患者中隐球菌抗原血症的发生率很高，这一点令人震惊，并强调需要改善CD4状态，扩大血清隐球菌抗原筛查，并加强定期隐球菌抗原血症监测系统。
Cryptococcosis is the most common opportunistic fungal infection. High morbidity and mortality are frequently observed among hospitalized HIV/AIDS patients, particularly having CD4 count ≤100 cells/μl. Therefore, this study aimed to determine the prevalence of cryptococcal antigenemia and associated factors among HIV/AIDS patients. A hospital-based cross-sectional study was conducted among 140 HIV/AIDS patients. A cryptococcal antigen test was performed for all patients along with medical chart and laboratory registration book review. Cryptococcal antigen was detected from serum by using Remel Cryptococcal Antigen Test Kit. Data related to possible associated factors were extracted from patients' charts and laboratory registration book. Data were coded, entered, and analyzed using SPSS version 20. Logistic regression analysis was done to see the association between dependent and independent variables. A P value <0.05 was considered statistically significant. Finally, data were presented in the form of texts, figures, and tables. Among 140 serum cryptococcal antigenemia-tested study subjects, 16 (11.43%) were positive for serum cryptococcal antigen. Of them, 43.8% (7/16) were pulmonary tuberculosis coinfected, 31.2% (5/16) were extrapulmonary tuberculosis positive, and 25% (4/16) had bacterial bloodstream infections. In addition, 68.7% (11/16) had CD4 count less than 100 cells/μl, 18.7% (3/16) had CD4 count 100–150 cells/μl, 50% (8/16) were antiretroviral therapy defaulters, and 31.3% (5/16) were naïve. In this study, the majority, 75% (12/16), of the serum cryptococcal antigen-positive subjects were clinical stage IV. Of the assessed associated factors, tuberculosis coinfection (AOR: 0.04; 95% CI [0.005–0.25]) and antiretroviral therapy status (AOR: 0.02; 95% CI [0.001–0.5]) were significantly associated factors enhancing serum cryptococcal antigenemia. In this study, the high rate of cryptococcal antigenemia was observed among hospitalized HIV/AIDS patients, and it is alarming and highlights the need for improving CD4 status, expanding serum cryptococcal antigen screening, and strengthening regular cryptococcal antigenemia surveillance systems.