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.
Antifungal susceptibility testing; Cryptococcal antigen screening; Cryptococcosis; DRC; Molecular characterization; People living with HIV; Antigens, Fungal; Humans; Democratic Republic of the Congo/epidemiology; Female; Male; Adult; Middle Aged; Cross-Sectional Studies; Multilocus Sequence Typing; Prevalence; 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; Cryptococcus neoformans; Democratic Republic of the Congo; HIV Infections; Meningitis, Cryptococcal; Multidisciplinary
Abstract :
[en] 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.
Disciplines :
Microbiology
Author, co-author :
Zono, Bive ; Université de Liège - ULiège > Unités de recherche interfacultaires > Centre Interdisciplinaire de Recherche sur le Médicament (CIRM) ; Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo. bive.zono@unikin.ac.cd
Sacheli, Rosalie ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Bactériologie, mycologie, parasitologie, virologie et microbiologie
Kasumba, Dacquin Muhandwa ; Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo ; Laboratory of Clinical Immunology, Institut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of Congo
Situakibanza, Hippolyte Nani-Tuma ; Infectious Diseases Service, Department of Internal Medicine, Department of Tropical Medicine, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
Mavanga, Alphonse; Medical and psychosocial management Unit for PLHIV, Internal Medicine Department, Centre Médical et Evangélique Révérend Luyindu, Kinshasa, Democratic Republic of Congo
Anyshayi, Justin Mwambi; Medical and psychosocial management Unit for PLHIV, Internal Medicine Department, Centre Hospitalier Roi Baudouin 1 er, Kinshasa, Democratic Republic of Congo
Etondo, Mamie; Medical and psychosocial management Unit for PLHIV, Internal Medicine Department, Centre Hospitalier Mère et Enfant de Ngaba, Kinshasa, Democratic Republic of Congo
Muwonga, Jérémie ; HIV/AIDS National Reference Laboratory (LNRS), HIV/AIDS National Control Programme, Kinshasa, Democratic Republic of Congo ; Department of Medical Biology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
Moutschen, Michel ; Université de Liège - ULiège > GIGA > GIGA I3 - Immunology & Infectious Diseases
Mvumbi, Georges Lelo ; Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
Hayette, Marie-Pierre ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Bactériologie, mycologie, parasitologie, virologie et microbiologie
Language :
English
Title :
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.
The authors express their thanks to the Acad\u00E9mie de Recherche et d\u2019Enseignement Sup\u00E9rieur (ARES-CCD) for its support. We also thank Professor Ferry Hagen of the Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute (WI-KNAW), Uppsalalaan 8, 3584CT Utrecht, The Netherlands, for the independent critical review of this manuscript.
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