Prevalence of Disseminated Cryptococcosis among Human Immunodeficiency Virus Infected Patients in Benin City, Nigeria

Abstract

Aim: To determine the prevalence of disseminated cryptococcosis among symptomatic HIV-infected patients, attending the Antiretroviral Treatment Clinic at the University of Benin Teaching Hospital, Benin City, Nigeria. Study Design: Cross-sectional study. Place and Duration of Study: Department of Internal Medicine and Department of Medical Microbiology, University of Benin Teaching Hospital, Edo State, Nigeria, between September 2010 and August 2011. Methodology: Five hundred consecutive symptomatic HIV-infected patients, on ART were enrolled into this cross-sectional study (266 males, 234 females, age range 18-81 years, mean age, 40.08 years). A blood sample collected from each participant was screened for serum cryptococcal antigen (CRAG) using the cryptococcal Latex agglutination test. The viral load and CD4+ T -cell count were also determined in parallel. A structured questionnaire was used to gather Information on socio demographic characteristics, medical and treatment history of participants. Data collected and the results of laboratory tests were analyzed using the SPSS software, version 22.0. Results: The prevalence of serum cryptococcal antigen was 9.8%. Majority (66.8%) of the participants had a CD4+ T-cell count of less than 100 cells/µl. The association between serum CRAG and CD4+ T-cell was found to be significant (P < .001). Viral load done for only 90 of the participants was high in 51.1%. The association between serum CRAG and viral load was found to be significant (P < .001). Conclusion: The prevalence of serum CRAG was high among symptomatic HIV- infected patients on ART, in Benin city, Nigeria, despite ART implementation. There is need therefore for a routine cryptococcal antigen test for all symptomatic HIV-infected patients on ART, while further microbiological investigations for those with positive result are recommended for appropriate medical intervention.