Table 2: Summary of published studies regarding cryptococcal antigenaemia in HIV-positive patients.

Author, year of publication, referenceCountryType of study/PopulationCrAg asymptomatic prevalenceAll CrAg positiveComment

Africa

Desmet et al., 1998 [106]Kinshasa, ZaireCohort/450 adults15/450 (3.3%)55/450 (12.2%)29 out of 44 had CSF positive microscopy/culture for C.  neoformans
French et al., 2002 [28]Entebbe, UgandaCohort/1372 adults7/77 (9.1%)77/1372 (6.6%)CrAg preceded onset of symptoms by a median of 22 days
Tassie et al., 2003 [107]Mbarara, UgandaCohort/197 adults8/197 (4.1%)21/197 (10.7%)13 pts had CM
Liechty et al., 2007 [108]Kampala, UgandaRetrospective/395 adults22/377 (5.8) 44/395 (11.1) 7 pts newly diagnosed with CM, 3 of whom had a positive serum CrAg at baseline; asymptomatic CrAg independent risk factor for death (RR 6.6)
Jarvis et al., 2009 [109]Cape Town, South AfricaRetrospective/707 adults25/707 (3.5)*46/707 (7%)13 out of 46 (28%) developed new or relapsed CM; CrAg independent risk factor for death (HR 3.1)
Meya et al., 2010 [110]Kampala, UgandaProspective cohort/609 adults33/592 (5.6%)
26/295 (8.8% incidence) < 100 CD4+/μL
7/298 (2.3%)
> 100 CD4+/μL
50/609 (8.2%)17 had pre-Art diagnosed CM; preemptive treatment cost-effective (NNTac 6.5; NNTad 10)
Mamoojee et al., 2011 [111]Kumasi, GhanaRetrospective/92 adults2/92 (2%)2/92 (2%)This study suggested a limited value of CrAg testing in this area
Oyella et al., 2012 [112]Kampala, UgandaCross-sectional/367 adults45/367 (12.2%)69/367 (18.8%)Only 30 pts undergo lumbar puncture; 24 out of 30 had CM

South-east Asia

Micol et al., 2007 [113]Phnom Penh, CambodiaProspective cohort/327 adults10/327 (3.1%)58/327 (17.7 %)41 pts had CM
Pongsai et al., 2010 [114]Bangkok, ThailandRetrospective/131 adults8/131 (6.1%)12/131 (9.2%)3 out of 12 had CM, 1 pulmonary cryptococcosis

Europe and USA

Feldmesser et al., 1996 [115]USACase series/10 adults7/10 (70%)10First study about isolated CrAg
Patel et al., 2013 [116]London, UKRetrospective/157 adults1/157 (0.6%)7/157 (4.4%)7 pts diagnosed with CM

CrAg: cryptococcal antigenemia, CM: cryptococcal meningitis, UK: United Kingdom; RR: relative risk; HR: hazard ratio; NNTac: number needed to treat to avoid a case; NNTad: number needed to treat to avoid death.
*Only patients without a history of cryptococcal meningitis were considered.