Abstract
Cryptococcal meningitis (CM) contributes significantly to high early mortality in the setting of advanced HIV. In resource poor settings, the current HIV disease management approach is focused on commencing antiretroviral therapy (ART) on the same day of HIV diagnosis (‘Test and Treat’). The HIV program in Nigeria does not currently provide CrAg screening for patients with newly diagnosed and advanced HIV disease. We report a case of severe cryptococcal meningitis presenting following the commencement of ART. There is clear benefit in the early commencement of ART among HIV infected patients and to prevent patients lost to follow-up as aimed with the ‘Test & Treat’ approach. However, this approach needs to be balanced against the risk of IRIS and its associated morbidity and mortality when those patients are not being properly evaluated for opportunistic infections being present without overt symptoms.
| Original language | English |
|---|---|
| Pages (from-to) | 58-60 |
| Number of pages | 3 |
| Journal | Medical mycology case reports |
| Volume | 24 |
| Early online date | 16 Apr 2019 |
| DOIs | |
| Publication status | Published - Jun 2019 |
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Keywords
- Cryptococcal meningitis
- HIV
- IRIS
- Nigeria
- Test and Treat
ASJC Scopus subject areas
- Microbiology
- Infectious Diseases
Cite this
Cryptococcal meningitis after ART : Need for proper baseline evaluation in the era of ‘Test & Treat’. / Akase, Iorhen E. (Corresponding Author); Olowoyo, Olamide; Oladele, Rita O.; Obiako, Reginald O.; Warris, Adilia; Akanmu, Sulaimon A.
In: Medical mycology case reports, Vol. 24, 06.2019, p. 58-60.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cryptococcal meningitis after ART
T2 - Need for proper baseline evaluation in the era of ‘Test & Treat’
AU - Akase, Iorhen E.
AU - Olowoyo, Olamide
AU - Oladele, Rita O.
AU - Obiako, Reginald O.
AU - Warris, Adilia
AU - Akanmu, Sulaimon A.
PY - 2019/6
Y1 - 2019/6
N2 - Cryptococcal meningitis (CM) contributes significantly to high early mortality in the setting of advanced HIV. In resource poor settings, the current HIV disease management approach is focused on commencing antiretroviral therapy (ART) on the same day of HIV diagnosis (‘Test and Treat’). The HIV program in Nigeria does not currently provide CrAg screening for patients with newly diagnosed and advanced HIV disease. We report a case of severe cryptococcal meningitis presenting following the commencement of ART. There is clear benefit in the early commencement of ART among HIV infected patients and to prevent patients lost to follow-up as aimed with the ‘Test & Treat’ approach. However, this approach needs to be balanced against the risk of IRIS and its associated morbidity and mortality when those patients are not being properly evaluated for opportunistic infections being present without overt symptoms.
AB - Cryptococcal meningitis (CM) contributes significantly to high early mortality in the setting of advanced HIV. In resource poor settings, the current HIV disease management approach is focused on commencing antiretroviral therapy (ART) on the same day of HIV diagnosis (‘Test and Treat’). The HIV program in Nigeria does not currently provide CrAg screening for patients with newly diagnosed and advanced HIV disease. We report a case of severe cryptococcal meningitis presenting following the commencement of ART. There is clear benefit in the early commencement of ART among HIV infected patients and to prevent patients lost to follow-up as aimed with the ‘Test & Treat’ approach. However, this approach needs to be balanced against the risk of IRIS and its associated morbidity and mortality when those patients are not being properly evaluated for opportunistic infections being present without overt symptoms.
KW - Cryptococcal meningitis
KW - HIV
KW - IRIS
KW - Nigeria
KW - Test and Treat
UR - http://www.scopus.com/inward/record.url?scp=85064450219&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/cryptococcal-meningitis-after-art-need-proper-baseline-evaluation-era-test-treat
U2 - 10.1016/j.mmcr.2019.04.003
DO - 10.1016/j.mmcr.2019.04.003
M3 - Article
AN - SCOPUS:85064450219
VL - 24
SP - 58
EP - 60
JO - Medical mycology case reports
JF - Medical mycology case reports
SN - 2211-7539
ER -