What question did this study set out to answer?

To assess the utility of serum cryptococcal antigen screening in reducing hospital mortality in adults living with HIV.

January 14, 2026Open Access

P-257. Performance of Serum Cryptococcal Antigen for Early Detection of Cryptococcal Meningitis in People Living with HIV

VAVictor D Acuña-RochaHospital Universitario Dr José Eleuterio Gonzalez GIGabriel G. Ibarra-NúñezUniversidad Autónoma de Nuevo León ACAdrián Camacho-OrtízUniversidad Autónoma de Nuevo León

Key Points

To assess the utility of serum cryptococcal antigen screening in reducing hospital mortality in adults living with HIV.
Descriptive, retrospective, cross-sectional, and analytical study design
Included hospitalized adults (≥18 years) with HIV
Conducted tests for serum and CSF cryptococcal antigen and lumbar puncture for analysis
34.1% of participants tested positive for serum cryptococcal antigen
15.5% diagnosed with cryptococcal meningitis, more prevalent in antigen-positive group (27.3%)
No significant difference in hospital mortality despite early treatment

Abstract

Abstract Background The development of cryptococcal antigen (CrAg) detection methods, such as latex agglutination, ELISA, and lateral flow assays has significantly improved early diagnosis, achieving sensitivities and specificities between 99.1% and 100% (1-4). This study aimed to assess the utility of serum CrAg (SCrAg) screening and subsequent early treatment in reducing in-hospital mortality among people living with HIV (PLHIV) in a teaching hospital. Methods We conducted a descriptive, retrospective, cross-sectional, and analytical study of adults (≥18 years) living with HIV who were hospitalized in clinical stage C for any reason between December 2021 and June 2023 at the University Hospital “Dr. José Eleuterio González.” Clinical and laboratory data were collected from hospital records. Qualitative serum and CSF cryptococcal antigen (CrAg) were detected using the Cryptococcal Antigen Latex Agglutination System (Meridian Bioscience®). All patients with a positive serum CrAg (SCrAg) result underwent lumbar puncture for cytochemical analysis, India ink staining, microbiological culture, and CSF CrAg testing. Results A total of 129 people living with HIV (PLWHIV) were included in the study, of whom 85.3% (n=110) were male at birth. The median age was 36 years 30-45. Among the 129 PLWHIV, 34.1% (n=44) tested positive for serum cryptococcal antigen. In contrast, 65.9% (n=85) PLWHIV tested negative for serum cryptococcal antigen. Overall, CSF CrAg was positive in 19.4% of patients (n=7); this included 20% (n=6) of those with a positive serum CrAg (SCrAg) and 16.7% (n=1) of those with a negative SCrAg. India ink staining was positive in 9.9% (n=9) of the patients, and cryptococcal cultures in CSF were positive in 20.0% (n=17), with no difference in the antigen-positive group, 27.8% (n=10) vs the antigen-negative group, 14.3% (n=7) (p=0.124). Cryptococcal meningitis was diagnosed in 15.5% (n = 20) of patients, occurring more often in the serum antigen-positive group (27.3%, n = 12) compared to the serum antigen-negative group (9.4%, n = 8; p = 0.008). Conclusion Universal SCrAg screening in hospitalized PLWHIV increased lumbar puncture rates and cryptococcal meningitis diagnoses. However, despite early treatment, our results did not show a difference in hospital mortality. Disclosures All Authors: No reported disclosures

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