Looking for fungi in all the right places: screening for cryptococcal disease and other AIDS-related mycoses among patients with advanced HIV disease.
Identifieur interne : 000446 ( PubMed/Checkpoint ); précédent : 000445; suivant : 000447Looking for fungi in all the right places: screening for cryptococcal disease and other AIDS-related mycoses among patients with advanced HIV disease.
Auteurs : Greg Greene [Afrique du Sud] ; Charlotte Sriruttan ; Thuy Le ; Tom Chiller ; Nelesh P. GovenderSource :
- Current opinion in HIV and AIDS [ 1746-6318 ] ; 2017.
Descripteurs français
- KwdFr :
- Champignons (), Champignons (isolement et purification), Co-infection (diagnostic), Dépistage systématique (), Dépistage systématique (tendances), Humains, Infections fongiques invasives (), Infections fongiques invasives (diagnostic), Infections opportunistes liées au SIDA (diagnostic), Infections à VIH (), Tests diagnostiques courants (), Tests diagnostiques courants (tendances).
- MESH :
- diagnostic : Co-infection, Infections fongiques invasives, Infections opportunistes liées au SIDA.
- isolement et purification : Champignons.
- tendances : Dépistage systématique, Tests diagnostiques courants.
- Champignons, Dépistage systématique, Humains, Infections fongiques invasives, Infections à VIH, Tests diagnostiques courants.
English descriptors
- KwdEn :
- AIDS-Related Opportunistic Infections (diagnosis), Coinfection (diagnosis), Diagnostic Tests, Routine (methods), Diagnostic Tests, Routine (trends), Fungi (drug effects), Fungi (isolation & purification), HIV Infections (complications), Humans, Invasive Fungal Infections (diagnosis), Invasive Fungal Infections (prevention & control), Mass Screening (methods), Mass Screening (trends).
- MESH :
- complications : HIV Infections.
- diagnosis : AIDS-Related Opportunistic Infections, Coinfection, Invasive Fungal Infections.
- drug effects : Fungi.
- isolation & purification : Fungi.
- methods : Diagnostic Tests, Routine, Mass Screening.
- prevention & control : Invasive Fungal Infections.
- trends : Diagnostic Tests, Routine, Mass Screening.
- Humans.
Abstract
As HIV treatment programmes scale up to meet the UNAIDS 90-90-90 goals, care must be taken to start antiretroviral treatment safely in patients with advanced disease (CD4 counts <200 cells/μl) who are simultaneously at risk for opportunistic infections and immune reconstitution inflammatory syndrome. Invasive fungal diseases pose a great threat at this critical time point, though the development of inexpensive and highly accurate rapid diagnostic tests has changed the approach HIV programmes are taking to reduce the high mortality associated with these opportunistic infections. This article summarizes recent advances and findings in fungal opportunistic infection diagnostics with a focus on screening to prevent cryptococcal meningitis.
DOI: 10.1097/COH.0000000000000347
PubMed: 28134711
Affiliations:
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pubmed:28134711Le document en format XML
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<front><div type="abstract" xml:lang="en">As HIV treatment programmes scale up to meet the UNAIDS 90-90-90 goals, care must be taken to start antiretroviral treatment safely in patients with advanced disease (CD4 counts <200 cells/μl) who are simultaneously at risk for opportunistic infections and immune reconstitution inflammatory syndrome. Invasive fungal diseases pose a great threat at this critical time point, though the development of inexpensive and highly accurate rapid diagnostic tests has changed the approach HIV programmes are taking to reduce the high mortality associated with these opportunistic infections. This article summarizes recent advances and findings in fungal opportunistic infection diagnostics with a focus on screening to prevent cryptococcal meningitis.</div>
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<ArticleTitle>Looking for fungi in all the right places: screening for cryptococcal disease and other AIDS-related mycoses among patients with advanced HIV disease.</ArticleTitle>
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<Abstract><AbstractText Label="PURPOSE OF REVIEW" NlmCategory="OBJECTIVE">As HIV treatment programmes scale up to meet the UNAIDS 90-90-90 goals, care must be taken to start antiretroviral treatment safely in patients with advanced disease (CD4 counts <200 cells/μl) who are simultaneously at risk for opportunistic infections and immune reconstitution inflammatory syndrome. Invasive fungal diseases pose a great threat at this critical time point, though the development of inexpensive and highly accurate rapid diagnostic tests has changed the approach HIV programmes are taking to reduce the high mortality associated with these opportunistic infections. This article summarizes recent advances and findings in fungal opportunistic infection diagnostics with a focus on screening to prevent cryptococcal meningitis.</AbstractText>
<AbstractText Label="RECENT FINDINGS" NlmCategory="RESULTS">Cryptococcal antigen (CrAg) screening using a lateral flow assay platform is cost-effective and feasible to implement as either a laboratory reflex or point-of-care test. Recent CrAg screening pilots have elucidated the varying prevalence of cryptococcal antigenemia across geographic regions, which may aid programme planning. Evidence from recently completed clinical trials provides a strong motivation for the use of CrAg titer to refine treatment options for patients with subclinical cryptococcal disease.</AbstractText>
<AbstractText Label="SUMMARY" NlmCategory="CONCLUSIONS">Although several operational barriers to programme effectiveness still need to be addressed, the utility of CrAg screening using inexpensive and accurate antigen assays has been demonstrated in real-world HIV programmes, paving the way for development and testing of other fungal opportunistic infection screening strategies and for an integrated advanced HIV disease testing package to reduce AIDS mortality and ensure safe antiretroviral treatment initiation.</AbstractText>
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<name sortKey="Le, Thuy" sort="Le, Thuy" uniqKey="Le T" first="Thuy" last="Le">Thuy Le</name>
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<country name="Afrique du Sud"><region name="Gauteng"><name sortKey="Greene, Greg" sort="Greene, Greg" uniqKey="Greene G" first="Greg" last="Greene">Greg Greene</name>
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