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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Evaluation of a novel point-of-care cryptococcal antigen test on serum, plasma, and urine from patients with HIV-associated cryptococcal meningitis
Clinical Infectious Diseases, Volume 53, No. 10, Year 2011
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Description
Background. Many deaths from cryptococcal meningitis (CM) may be preventable through early diagnosis and treatment. An inexpensive point-of-care (POC) assay for use with urine or a drop of blood would facilitate early diagnosis of cryptococcal infection in resource-limited settings. We compared cryptococcal antigen (CRAG) concentrations in plasma, serum, and urine from patients with CM, using an antigen-capture assay for glucuronoxylomannan (GXM) and a novel POC dipstick test. Methods. GXM concentrations were determined in paired serum, plasma, and urine from 62 patients with active or recent CM, using a quantitative sandwich enzyme-linked immunosorbent assay (ELISA). A dipstick lateral-flow assay developed using the same monoclonal antibodies for the sandwich ELISA was tested in parallel. Correlation coefficients were calculated using Spearman rank test. Results. All patients had detectable GXM in serum, plasma, and urine using the quantitative ELISA. Comparison of paired serum and plasma showed identical results. There were strong correlations between GXM levels in serum/urine (rs = 0.86; P <. 001) and plasma/urine (rs = 0.85; P <. 001). Levels of GXM were 22-fold lower in urine than in serum/plasma. The dipstick test was positive in serum, plasma, and urine in 61 of 62 patients. Dipstick titers correlated strongly with ELISA. Correlations between the methods were 0.93 (P <. 001) for serum, 0.94 (P <. 001) for plasma, and 0.94 (P <. 001) for urine. Conclusions. This novel dipstick test has the potential to markedly improve early diagnosis of CM in many settings, enabling testing of urine in patients presenting to health care facilities in which lumbar puncture, or even blood sampling, is not feasible. © 2011 The Author Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Jarvis, Joseph N.
United Kingdom, London
St George’s, University of London
South Africa, Cape Town
University of Cape Town
South Africa, Cape Town
Gf Jooste Hospital
Percival, Ann
United States, Reno
University of Nevada School of Medicine
Bauman, Sean
United States, Norman
Immuno-mycologics (immy)
Pelfrey, Joy
United States, Norman
Immuno-mycologics (immy)
Meintjes, Graeme Ayton
South Africa, Cape Town
Gf Jooste Hospital
South Africa, Cape Town
University of Cape Town
United Kingdom, London
Imperial College London
Williams, G. Ntombomzi
South Africa, Cape Town
Gf Jooste Hospital
Longley, Nicola
United Kingdom, London
St George’s, University of London
South Africa, Cape Town
University of Cape Town
South Africa, Cape Town
Gf Jooste Hospital
Harrison, Thomas Stephen
United Kingdom, London
St George’s, University of London
Kozel, Thomas R.
United States, Reno
University of Nevada School of Medicine
Statistics
Citations: 292
Authors: 9
Affiliations: 6
Identifiers
Doi:
10.1093/cid/cir613
ISSN:
10584838
e-ISSN:
15376591
Research Areas
Infectious Diseases
Study Approach
Quantitative