Cryptococcosis primary prevention: Difference between revisions
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*Practice safe sex to reduce the risk of getting [[HIV]] and the infections associated with a weakened immune system. | *Practice safe sex to reduce the risk of getting [[HIV]] and the infections associated with a weakened immune system. | ||
*[[Cryptococcosis|Cryptococcal]] meningitis commonly affects patients with [[CD4]] count are ≤ 100 cells/μl. It is responsible for major cause of [[mortality]] and [[morbidity]] in [[Human Immunodeficiency Virus (HIV)|HIV]] individuals. It is recommended that patients with [[CD4]] counts ≤ 100 cells/μl, should have routine [[Cryptococcosis|cryptococcal]] antigen screening. Patients with positive result are offered preemptive [[Antifungal drug|anti-fungal therapy]].<ref name="pmid28166254">{{cite journal| author=Cassim N, Schnippel K, Coetzee LM, Glencross DK| title=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. | journal=PLoS One | year= 2017 | volume= 12 | issue= 2 | pages= e0171675 | pmid=28166254 | doi=10.1371/journal.pone.0171675 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28166254 }} </ref><ref name="pmid28134711">{{cite journal| author=Greene G, Sriruttan C, Le T, Chiller T, Govender NP| title=Looking for fungi in all the right places: screening for cryptococcal disease and other AIDS-related mycoses among patients with advanced HIV disease. | journal=Curr Opin HIV AIDS | year= 2017 | volume= 12 | issue= 2 | pages= 139-147 | pmid=28134711 | doi=10.1097/COH.0000000000000347 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28134711 }} </ref> | *[[Cryptococcosis|Cryptococcal]] meningitis commonly affects patients with [[CD4]] count are ≤ 100 cells/μl. It is responsible for major cause of [[mortality]] and [[morbidity]] in [[Human Immunodeficiency Virus (HIV)|HIV]] individuals. It is recommended that patients with [[CD4]] counts ≤ 100 cells/μl, should have routine [[Cryptococcosis|cryptococcal]] antigen screening. Patients with positive result are offered preemptive [[Antifungal drug|anti-fungal therapy]].<ref name="pmid28166254">{{cite journal| author=Cassim N, Schnippel K, Coetzee LM, Glencross DK| title=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. | journal=PLoS One | year= 2017 | volume= 12 | issue= 2 | pages= e0171675 | pmid=28166254 | doi=10.1371/journal.pone.0171675 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28166254 }} </ref><ref name="pmid28134711">{{cite journal| author=Greene G, Sriruttan C, Le T, Chiller T, Govender NP| title=Looking for fungi in all the right places: screening for cryptococcal disease and other AIDS-related mycoses among patients with advanced HIV disease. | journal=Curr Opin HIV AIDS | year= 2017 | volume= 12 | issue= 2 | pages= 139-147 | pmid=28134711 | doi=10.1097/COH.0000000000000347 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28134711 }} </ref> | ||
*One strategy to prevent cryptococcal meningitis deaths is to treat all HIV/AIDS patients with a CD4 <100 with low-dose uconazole, such as 200 mg daily. This strategy has been shown to decrease the number of cryptococcal infections, but has not consistently been shown to decrease rates of death from cryptococcal disease.<ref name="urlwww.cdc.gov">{{cite web |url=https://www.cdc.gov/fungal/pdf/crypto-screen-train-manual_508c.pdf |title=www.cdc.gov |format= |work= |accessdate=}}</ref> | |||
==References== | ==References== | ||
Revision as of 18:35, 5 June 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Primary Prevention
- Take the lowest doses of corticosteroid medications possible.
- Practice safe sex to reduce the risk of getting HIV and the infections associated with a weakened immune system.
- Cryptococcal meningitis commonly affects patients with CD4 count are ≤ 100 cells/μl. It is responsible for major cause of mortality and morbidity in HIV individuals. It is recommended that patients with CD4 counts ≤ 100 cells/μl, should have routine cryptococcal antigen screening. Patients with positive result are 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 uconazole, such as 200 mg daily. This strategy has been shown to decrease the number of cryptococcal infections, but has not consistently been shown to decrease 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).