naa a22 4500 510735401 CHVBK 20180411083008.0 cr unu---uuuuu 180411e20130901xx s 000 0 eng 10.1007/s11904-013-0165-9 doi (NATIONALLICENCE)springer-10.1007/s11904-013-0165-9 Asymptomatic Cryptococcemia in Resource-Limited Settings [Elektronische Daten] [Ana-Claire Meyer, Mark Jacobson] Despite increasing availability of anti-retroviral therapy, invasive cryptococcal disease continues to be a leading cause of death among HIV-infected individuals in resource-limited settings. Screening asymptomatic HIV-infected individuals with advanced immunosuppression for serum cryptococcal antigen clearly identifies a population at high risk of cryptococcal meningitis and death. However, screening with serum cryptococcal antigen alone identifies a heterogeneous clinical population, many of whom have mild clinical symptoms, sub-clinical meningeal infection, or fungemia. Currently, there is wide variation in practice and little evidence to guide the use of anti-fungal and anti-retroviral treatment for asymptomatic cryptococcal antigenemia (ACA). Furthermore, implementing a targeted screening and treatment intervention for ACA presents numerous operational challenges for already overburdened health care systems in resource-limited settings. While such an intervention shows promise, there are critical gaps in our understanding of ACA and its implications in the outpatient setting and an urgent need for additional research in this area. Springer Science+Business Media New York, 2013 Cryptococcus nationallicence HIV/AIDS nationallicence Meningitis nationallicence Asymptomatic cryptococcal antigenemia nationallicence Resource-limited settings nationallicence Co-infections nationallicence Meyer Ana-Claire Department of Neurology, San Francisco General Hospital, University of California, San Francisco, 1001 Potrero Avenue, Bldg 1, Room 101, 94110, San Francisco, CA, USA aut Jacobson Mark Positive Health Program, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, 94110, San Francisco, CA, USA aut Current HIV/AIDS Reports Springer US; http://www.springer-ny.com 10/3(2013-09-01), 254-263 1548-3568 10:3<254 2013 10 11904 https://doi.org/10.1007/s11904-013-0165-9 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11904-013-0165-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Meyer Ana-Claire Department of Neurology, San Francisco General Hospital, University of California, San Francisco, 1001 Potrero Avenue, Bldg 1, Room 101, 94110, San Francisco, CA, USA aut NATIONALLICENCE 700 1- Jacobson Mark Positive Health Program, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, 94110, San Francisco, CA, USA aut NATIONALLICENCE 773 0- Current HIV/AIDS Reports Springer US; http://www.springer-ny.com 10/3(2013-09-01), 254-263 1548-3568 10:3<254 2013 10 11904 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer