Performance of Cryptococcal Antigen Lateral Flow Assay Using Saliva in Ugandans with CD4 ,<100

dc.contributor.authorKwizera, Richard
dc.contributor.authorNguna, Joyce
dc.contributor.authorKiragga, Agnes
dc.contributor.authorNakavuma, Jesca
dc.contributor.authorRajasingham, Radha
dc.contributor.authorBoulware, David R.
dc.contributor.authorMeya, David B.
dc.date.accessioned2022-08-18T19:16:07Z
dc.date.available2022-08-18T19:16:07Z
dc.date.issued2014
dc.description.abstractCryptococcal meningitis can best be diagnosed by cerebrospinal fluid India ink microscopy, cryptococcal antigen detection, or culture. These require invasive lumbar punctures. The utility of cryptococcal antigen detection in saliva is unknown. We evaluated the diagnostic performance of the point-of-care cryptococcal antigen lateral flow assay (CrAg LFA) in saliva.We screened HIV-infected, antiretroviral therapy naïve persons with symptomatic meningitis (n = 130) and asymptomatic persons with CD4+<100 cells/µL entering into HIV care (n = 399) in Kampala, Uganda. The diagnostic performance of testing saliva was compared to serum/plasma cryptococcal antigen as the reference standard.The saliva lateral flow assay performance was overall more sensitive in symptomatic patients (88%) than in asymptomatic patients (27%). The specificity of saliva lateral flow assay was excellent at 97.8% in the symptomatic patients and 100% in asymptomatic patients. The degree of accuracy of saliva in diagnosing cryptococcosis and the level of agreement between the two sample types was better in symptomatic patients (C-statistic 92.9, κ-0.82) than in asymptomatic patients (C-statistic 63.5, κ-0.41). Persons with false negative salvia CrAg tests had lower levels of peripheral blood CrAg titers (P<0.001).There was poor diagnostic performance in testing saliva for cryptococcal antigen, particularly among asymptomatic persons screened for preemptive treatment of cryptococcosis.en_US
dc.identifier.citationKwizera, R., Nguna, J., Kiragga, A., Nakavuma, J., Rajasingham, R., Boulware, D. R., & Meya, D. B. (2014). Performance of cryptococcal antigen lateral flow assay using saliva in Ugandans with CD4< 100. PloS one, 9(7), e103156.https://doi.org/10.1371/journal.pone.0103156en_US
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/4300
dc.language.isoenen_US
dc.publisherPloS oneen_US
dc.titlePerformance of Cryptococcal Antigen Lateral Flow Assay Using Saliva in Ugandans with CD4 ,<100en_US
dc.typeArticleen_US
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