Page 14 - SAHCS HIVMed Journal Vol 20 No 1 2019

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 16 Guideline

Southern African HIV Clinicians Society guideline for the

prevention, diagnosis and management of cryptococcal

disease among HIV-infected persons: 2019 update

Authors: Introduction
Nelesh P. Govender 1,2,3
Graeme Meintjes Rationale for guideline update
4,5
Phetho Mangena 6 Six years after the Southern African HIV Clinicians Society cryptococcal disease guideline was
Jeremy Nel 7
Samantha Potgieter 8 published in 2013, cryptococcal meningitis (CM) remains an important cause of mortality
Denasha Reddy 9 among antiretroviral treatment (ART)-naïve and ART-experienced HIV-seropositive adults in
Helena Rabie South Africa. Several important practice-changing developments led us to update the guideline
10
1,2
Douglas Wilson 11,12
John Black to diagnose, prevent and manage this common fungal opportunistic infection. The World Health
13
David Boulware Organization (WHO) published a guideline for advanced HIV disease in 2017 and a guideline
14
Tom Boyles 15,16 relevant to resource-limited settings for HIV-associated CM in 2018. Cryptococcal antigen
3,4
Tom Chiller
17
Halima Dawood 18,19 (CrAg) screening and pre-emptive treatment reduced all-cause mortality among ambulatory
Sipho Dlamini participants in a randomised clinical trial in Zambia and Uganda. Following an evaluation
20
5
Thomas S. Harrison of reflex versus provider-initiated screening, national reflex laboratory CrAg screening was
21
Prudence Ive 16,22
6,7
Joseph Jarvis implemented in South Africa in 2016. Recently completed clinical trials conducted in resource-
23
Alan Karstaedt 16,24 limited settings have provided evidence for the best first-line antifungal regimens for CM and the
Matamela C. Madua
25
Colin Menezes 9,16
Mahomed-Yunus S. Moosa 4 Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
26
Zaaheera Motlekar 27 5 Department of Medicine, University of Cape Town, Cape Town, South Africa
Amir Shroufi 6 Department of Medicine, Polokwane Hospital, Polokwane, South Africa
17
Sarah Lynn Stacey 16,28 7 Helen Joseph Hospital, University of the Witwatersrand, Johannesburg, South Africa
Merika Tsitsi 9,16 8 Department of Internal Medicine, University of the Free State, Bloemfontein, South Africa
Gilles van Cutsem 29,30 9 Division of Infectious Diseases, Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, University of the
Ebrahim Variava 16,31 Witwatersrand, Johannesburg, South Africa
Michelle Venter 9,16 10 Department of Paediatrics, Tygerberg Hospital, Stellenbosch University, Stellenbosch, South Africa
Rachel Wake 1,21 11 Department of Internal Medicine, Edendale Hospital, Pietermaritzburg, South Africa
12 School of Clinical Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa
Affiliations: 13 Department of Infectious Diseases, Livingstone Hospital, Port Elizabeth, South Africa
1 National Institute for 14 Department of Medicine, Centre for Infectious Diseases and Microbiology Translational Research, University of Minnesota, Minneapolis,
Communicable Diseases, United States
a Division of the National 15 Anova Health Institute, Johannesburg, South Africa
Health Laboratory Service, 16 Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Johannesburg, South Africa 17 Mycotic Diseases Branch, US Centres for Disease Control and Prevention, Atlanta, United States
18 Department of Medicine, Grey’s Hospital, Pietermaritzburg, South Africa
2 School of Pathology, 19 Caprisa, University of KwaZulu-Natal, Pietermaritzburg, South Africa
University of the 20 Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town,
Witwatersrand, Cape Town, South Africa
Johannesburg, South Africa 21 Centre for Global Health, Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
22 Division of Infectious Diseases, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, Helen Joseph
3 Division of Medical Hospital, Johannesburg, South Africa
Microbiology, University of 23 Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London,
Cape Town, Cape Town, United Kingdom
Division of Infectious Diseases, Department of Internal Medicine, Charlotte Maxeke Johannesburg Hospital, Johannesburg,
South Africa 24 South Africa
25 Department of Medicine, Rob Ferreira Hospital, Mbombela, South Africa
26 Department of Infectious Diseases, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
27 Department of Medicine, Kimberley Provincial Hospital, Kimberley, South Africa
28 Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
29 Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa
30 Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa
31 Department of Medicine, Tshepong Hospital, Klerksdorp, South Africa
Read online: Corresponding author: Nelesh Govender, [email protected]
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Scan this QR Dates: Received: 05 Sept. 2019 | Accepted: 12 Sept. 2019 |Published: 08 Nov. 2019
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