November 15, 2016
By the time the vast majority of people who have HIV reach testing and treatment for the virus, they have had it long enough, Greg Greene of the U.S. Centers for Disease Control and Prevention said [at the American Society of Tropical Medicine and Hygiene 65th Annual Meeting], that they are vulnerable to deadly fungal infections.
One, cryptococcal meningitis, causes 11 percent of HIV-related deaths globally, alone, he said. In sub- Saharan Africa where 500,000 cases occur annually, the toll is much higher, and in South Africa, the fungal infection causes 29 percent of HIV-related deaths. And even with efforts to meet UNAIDS targets of diagnosing 90 percent of all people with HIV, ensuring treatment access to 90 percent of them, and ensuring that treatment is effective in suppressing the virus in 90 percent of them, without the use of existing tools against the fungal infection, it will continue to take an unnecessary toll, he said.
Tools to control the toll of the infection include an inexpensive point-of-care cryptococcal meningitis diagnostic test and World Health Organization guidelines to screen for the infection in all individuals with a CD4, or immune cell, count less that 100 per milliliter of blood. Both are important because early intervention can be life-saving. The antigen for cryptococcal meningitis is detectable in the blood three weeks prior to the development of meningitis and the antifungal drug fluconazole can prevent the infection from disseminating throughout the body.
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