Prevalence and factors associated with cryptococcal antigenemia in HIV-infected patients in Cotonou/Benin

Objective Determine the prevalence of cryptococcal antigenemia and associated factors in HIV-infected patients in Cotonou in order to introduce systematic screening in national guidelines. Patients and methods This is a cross-sectional, descriptive and analytical study conducted from June to September 2015 in four outpatient treatment centers with adult patients infected with HIV, receiving or not antiretroviral treatment with a number of CD4 ≤ 200 cell/μL and who have given their informed consent to participate in the study. For each enrolled patient, after signing the informed consent form, it was made a clinical examination and administration of a questionnaire to collect general information, treatment and biological data. Then a blood sample for counting CD4 lymphocytes and the search of cryptococcal antigenemia were done. Results In total, 355 patients were included in the study with a mean age of 40 ± 10.2 years. The overall prevalence of cryptococcal antigenemia is 1.7%. All patient with cryptococcal antigenemia have a CD4 count below 100 cells/μL with a majority having CD4 count below 50 cells/μL. Body mass index < 18.5 kg/m2, an alteration of the general condition with a CD4 lymphocyte counts < 50 cells/μL are the main factors associated with the occurrence of cryptococcal antigenemia. Conclusion This pilot study showed a low prevalence of cryptococcal antigenemia in the study population, but higher in highly immuno-deficient patients with CD4 counts < 50 cells/μl. Given the results obtained, the introduction of routine screening among patients infected with HIV could be reserved to those with CD4 counts < 50 cells/μl.