Page 28 - SAHCS HIVMed Journal Vol 20 No 1 2019
P. 28

Page 15 of 16  Guideline


              disseminated TB, including TBM. Cerebrospinal fluid cell   5.  Mfinanga S, Chanda D, Kivuyo SL, et al. Cryptococcal meningitis screening and
              profiles and protein levels in CM are similar to those seen in   community-based early adherence support in people with advanced HIV infection
                                                                      starting antiretroviral therapy in Tanzania and Zambia: An open-label, randomised
              TBM.  However, a positive CrAg test or fungal culture is   controlled  trial.  Lancet.  2015;385(9983):2173–2182.  https://doi.org/10.1016/
                  65
                                                                      S0140-6736(15)60164-7
              diagnostic for CM, and concomitant TBM is then less likely.    6.  Govender  NP,  Glencross  DK.  National  coverage  of  reflex  cryptococcal  antigen
                                                             66
              All patients with CM relapse or cryptococcal IRIS should have   screening: A milestone achievement in the care of persons with advanced HIV
              diagnostic tests performed for concomitant TB with CSF and   disease. S Afr Med J. 2018;108(7):534–535. https://doi.org/10.7196/SAMJ.2018.
                                                                      v108i7.13094
              sputum GeneXpert Ultra assay, urinary lipoarabinomannan   7.  Larson  BA,  Rockers  PC,  Bonawitz  R,  et  al.  Screening  HIV-infected  patients
              assay and chest radiograph (although pulmonary TB and   with  low  CD4  counts  for  cryptococcal  antigenemia  prior  to  initiation  of
                                                                      antiretroviral therapy: Cost effectiveness of alternative screening strategies in
              cryptococcosis are difficult to distinguish radiologically).  South Africa. PLoS One. 2016;11(7):e0158986. https://doi.org/10.1371/journal.
                                                                      pone.0158986
                                                                    8.  Molloy  SF,  Kanyama  C,  Heyderman  RS,  et  al.  Antifungal  combinations  for
              Acknowledgements                                        treatment of cryptococcal meningitis in Africa. N Engl J Med. 2018;378(11):1004–
                                                                      1017. https://doi.org/10.1056/NEJMoa1710922
              Competing interests                                   9.  Day  J,  Imran  D,  Ganiem  AR,  et  al.  CryptoDex:  A  randomised,  double-blind,
                                                                      placebo-controlled  phase  III  trial  of  adjunctive  dexamethasone  in  HIV-infected
              The authors declare that they have no financial or personal   adults with cryptococcal meningitis: Study protocol for a randomised control trial.
                                                                      Trials. 2014;15:441. https://doi.org/10.1186/1745-6215-15-441
              relationships which may have inappropriately influenced   10. Govender NP, Meintjes G, Banoo S. Access to flucytosine for HIV-infected patients
              them in writing this article.                           with cryptococcal meningitis – An urgent need. S Afr Med J. 2014;104(9):594–
                                                                      595. https://doi.org/10.7196/SAMJ.8713
                                                                    11. National  Department  of  Health.  National  consolidated  guidelines  for  the
              Authors’ contributions                                  prevention of mother-to-child transmission of HIV and the management of HIV
                                                                      in children, adolescents and adults [homepage on the Internet]. Pretoria, South
              N.P.G. and G.M. chaired the guideline panel. P.M., J.N., S.P.,   Africa: National Department of Health; 2015 [cited 02 September 2019]. Available
                                                                      from:  http://www.health.gov.za/index.php/2014-03-17-09-09-38/policies-and-
              D.R. and D.W. drafted sections of the document. N.P.G.   guidelines/category/230-2015p.
              compiled the guideline document and worked on editing   12. National Department of Health. 2019 ART clinical guidelines for the management
                                                                      of  HIV  in  adults,  pregnancy,  adolescents,  children,  infants  and  neonates
              and reviewing with G.M. The rest of the authors listed   [homepage  on  the  Internet].  Pretoria,  South  Africa:  National  Department  of
              contributed equally.                                    Health; 2019 [cited 02 September 2019]. Available from: http://www.health.gov.
                                                                      za/index.php/2014-03-17-09-09-38/policies- and-guidelines/.
                                                                    13. Ford  N,  Shubber  Z,  Jarvis  JN,  et  al.  CD4  cell  count  threshold  for  cryptococcal
              Ethical considerations                                  antigen  screening  of  HIV-infected  individuals:  A  systematic  review  and  meta-
                                                                      analysis.  Clin  Infect  Dis.  2018;66(suppl_2):S152–S159.  https://doi.org/10.1093/
                                                                      cid/cix1143
              This article followed all ethical standards for a research   14. Tugume  L,  Rhein  J,  Hullsiek  KH,  et  al.  HIV-associated  cryptococcal  meningitis
              without direct contact with human or animal subjects.   occurring  at  relatively  higher  CD4  counts.  J  Infect  Dis.  2019;219(6):877–883.
                                                                      https://doi.org/10.1093/infdis/jiy602
                                                                    15.  Meiring ST, Quan VC, Cohen C, et al. A comparison of cases of paediatric-onset and adult-
              Funding information                                     onset cryptococcosis detected through population-based surveillance, 2005–2007.
                                                                      AIDS. 2012;26(18):2307–2314. https://doi.org/10.1097/QAD.0b013e3283570567
              This  research  received  no  specific  grant from any  funding   16. Vallabhaneni S, Longley N, Smith M, et al. Implementation and operational research:
                                                                      Evaluation of a public-sector, provider-initiated cryptococcal antigen screening and
              agency in the public, commercial, or not-for-profit sectors.  treatment  program,  Western  Cape,  South  Africa.  J  Acquir  Immune  Defic  Syndr.
                                                                      2016;72(2):e37–e42. https://doi.org/10.1097/QAI.0000000000000976
                                                                    17. Jarvis  JN,  Percival  A,  Bauman  S,  et  al.  Evaluation  of  a  novel  point-of-care
              Data availability statement                             cryptococcal antigen test on serum, plasma, and urine from patients with HIV-
                                                                      associated  cryptococcal  meningitis.  Clin  Infect  Dis.  2011;53(10):1019–1023.
              Data sharing is not applicable to this article as no new data   https://doi.org/10.1093/cid/cir613
              were created or analysed in this study.               18. Wake RM, Britz E, Sriruttan C, et al. High cryptococcal antigen titers in blood are
                                                                      predictive of subclinical cryptococcal meningitis among human immunodeficiency
                                                                      virus-infected  patients.  Clin  Infect  Dis.  2018;66(5):686–692.  https://doi.
                                                                      org/10.1093/cid/cix872
              Disclaimer                                            19. Meintjes G, Carmona S, Davies N, et al. Adult antiretroviral therapy guidelines
                                                                      2017.  S  Afr  J  HIV  Med.  2017;18(1):a776.  https://doi.org/10.4102/sajhivmed.
              The views and opinions expressed in this article are those of   v18i1.776
              the authors and do not necessarily reflect the official policy or   20. Rajasingham  R,  Wake  RM,  Beyene  T,  Katende  A,  Letang  E,  Boulware  DR.
                                                                      Cryptococcal  meningitis  diagnostics  and  screening  in  the  era  of  point-of-care
              position of any affiliated agency of the authors.       laboratory  testing.  J  Clin  Microbiol.  2019;57(1),pii:e01238–18.  https://doi.
                                                                      org/10.1128/JCM.01238-18
              References                                            21. Wake  RM,  Govender  NP,  Omar  T,  et  al.  Cryptococcal-related  mortality  despite
                                                                      fluconazole pre-emptive treatment in a cryptococcal antigen (CrAg) screen-and-
                                                                      treat programme. Clin Infect Dis. 2019;June 8,pii:ciz485. https://doi.org/10.1093/
              1.  Southern African HIV Clinicians Society. Guideline for the prevention, diagnosis   cid/ciz485
                and  management  of  cryptococcal  meningitis  among  HIV-infected  persons:   22. Boulware DR, Meya DB, Muzoora C, et al. Timing of antiretroviral therapy after
                2013  update.  S  Afr  J  HIV  Med.  2013;14(2):a82.  https://doi.org/10.7196/  diagnosis  of  cryptococcal  meningitis.  N  Engl  J  Med.  2014;370(26):2487–2498.
                sajhivmed.930.                                        https://doi.org/10.1056/NEJMoa1312884
              2.  National  Institute  for  Communicable  Diseases.  GERMS-SA  annual  report   23. Rhein  J,  Hullsiek  KH,  Evans  EE,  et  al.  Detrimental  outcomes  of  unmasking
                Johannesburg, South Africa [homepage on the Internet]. National Institute for   cryptococcal  meningitis  with  recent  ART  initiation.  Open  Forum  Infect  Dis.
                Communicable Diseases; 2017 [cited 02 September 2019]. Available from: http://  2018;5(8):ofy122. https://doi.org/10.1093/ofid/ofy122
                www.nicd.ac.za/publications/archives/.              24. Bright  PD,  Lupiya  D,  van  Oosterhout  JJ,  Chen  A,  Harrison  TS,  Chan  AK.  The
              3.  World Health Organization. Guidelines for managing advanced HIV disease and   treatment  of  a  pregnant  HIV  positive  patient  with  cryptococcal  meningitis  in
                rapid  initiation  of  antiretroviral  therapy  [homepage  on  the  Internet].  Geneva,   Malawi.  Case  report  and  review  of  treatment  options.  Med  Mycol  Case  Rep.
                                                                      2018;19:9–12. https://doi.org/10.1016/j.mmcr.2017.10.002
                Switzerland; 2017 [cited 02 September 2019]. Available from: https://www.who.
                int/hiv/pub/guidelines/advanced-HIV-disease/en/.    25. Perfect  JR,  Dismukes  WE,  Dromer  F,  et  al.  Clinical  practice  guidelines  for
              4.  World  Health  Organization.  Guidelines  for  the  diagnosis,  prevention  and   the  management  of  cryptococcal  disease:  2010  update  by  the  infectious
                                                                      diseases  society  of  america.  Clin  Infect  Dis.  2010;50(3):291–322.  https://doi.
                management of cryptococcal disease in HIV-infected adults, adolescents and   org/10.1086/649858
                children  [homepage  on  the  Internet].  Geneva,  Switzerland:  World  Health
                Organization; 2018 [cited 02 September 2019]. Available from: https://www.  26. University of Cape Town. South African Medicines Formulary (12th edn). Health
                who.int/hiv/pub/guidelines/cryptococcal-disease/en/   and Medical Publishing Group, Pretoria, 2016.
                                           http://www.sajhivmed.org.za  21  Open Access
   23   24   25   26   27   28   29   30   31   32   33