Screening for cryptococcal antigenemia and meningeal cryptococcosis, genetic characterization of Cryptococcus neoformans in asymptomatic patients with advanced HIV disease in Kinshasa, Democratic Republic of Congo.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Cryptococcus neoformans*/genetics ; Cryptococcus neoformans*/isolation & purification ; Antigens, Fungal*/blood ; Antigens, Fungal*/cerebrospinal fluid ; Meningitis, Cryptococcal*/epidemiology ; Meningitis, Cryptococcal*/diagnosis ; Meningitis, Cryptococcal*/cerebrospinal fluid ; Meningitis, Cryptococcal*/microbiology ; Meningitis, Cryptococcal*/blood ; HIV Infections*/complications ; HIV Infections*/blood; Humans ; Democratic Republic of the Congo/epidemiology ; Female ; Male ; Adult ; Middle Aged ; Cross-Sectional Studies ; Multilocus Sequence Typing ; Prevalence

We evaluated the prevalence of serum and meningeal cryptococcosis in asymptomatic outpatients with advanced HIV disease (CD4 < 200 cells/mm3) in a cross-sectional screening context in Kinshasa clinics (DRC). Lumbar puncture (LP) was performed in patients with positive serum cryptococcal antigen (CrAg) test, and Cryptococcus spp. isolated from cerebrospinal fluid (CSF) were identified by MALDI-TOF-MS, and characterized using serotyping-PCR, ITS-sequencing and multilocus sequence typing (MLST). The genetic profiles obtained were then compared with those of isolates previously described in symptomatic patients in the same clinics. Forty-seven patients with advanced HIV disease out of 262 included were positive for serum CrAg (18%, 95% CI: 14.2-24.3). The prevalence of asymptomatic cryptococcal meningitis (CM) was then measured at 50% among patients with positive serum CrAg test who consented to LP (19/38). Only four CSF samples were culture positive and all were characterized as Cryptococcus neoformans, molecular type VNI and belonging to two different sequence types (ST): ST93 (3/4) and ST63 (1/4). While ST93 is also the main genomic profile described in advanced HIV disease patients with symptomatic CM in Kinshasa clinics, ST63 has not yet been identified in DRC before. It is likely that future studies involving a large number of strains will be necessary before any definitive conclusions can be drawn on the involved strains in asymptomatic patients.
Competing Interests: Declarations. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)

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Keywords: Antifungal susceptibility testing; Cryptococcal antigen screening; Cryptococcosis; DRC; Molecular characterization; People living with HIV

0 (Antigens, Fungal)

Date Created: 20241202 Date Completed: 20241202 Latest Revision: 20241205

20241209

PMC11612378

10.1038/s41598-024-80772-w

39622937