摘要
隐球菌感染是艾滋病相关死亡最常见的原因之一。早期筛查发现隐球菌感染,提前进行抗隐球菌治疗,可明显减少艾滋病患者的病死率。我们组织相关专家制订了本共识。本共识推荐:(1)CD4+T淋巴细胞数<200个/μL的艾滋病患者应进行隐球菌抗原筛查;(2)侧向免疫层析法为艾滋病患者隐球菌感染筛查的首选方法;(3)血隐球菌抗原筛查阳性的艾滋病患者需进行脑脊液隐球菌抗原检测;(4)有条件的地区可开展血隐球菌抗原定量检测;(5)无症状的隐球菌抗原血症的艾滋病患者建议进行抢先的氟康唑抗隐球菌治疗;(6)血隐球菌抗原阳性,同时脑脊液隐球菌抗原阳性、隐球菌败血症、肺隐球菌病和其他部位隐球菌病的艾滋病患者,需按相关指南进行规范抗隐球菌治疗。
Cryptococcal infection is one of the most common causes of AIDS-related death. Early screening and early anti-cryptococcal treatment can significantly reduce the mortality of AIDS patients. This expert consensus recommends: 1.Patients with CD4+ T lymphocyte <200/μL should be screened for cryptococcal antigen;2. Lateral-flow assay should be the first choice for screening cryptococcus infection in AIDS patients;3.HIV patients with positive serum cryptococcal antigen (CrAg) in screening should be tested for CrAg in cerebrospinal fluid (CSF);4.The quantitative detection of CrAg can be carried out if feasible;5.AIDS patients with asymptomatic cryptococcal antigenemia should receive preemptive fluconazole anticryptococcal therapy;6. AIDS patients with positive serum CrAg, and positive CSF CrAg, cryptococcal septicemia, pulmonary cryptococcal disease or cryptococcal disease in other parts should receive standardized therapy according to the relevant anti-cryptococcal guidelines.
作者
浙江省医学会热带病和寄生虫病分会艾滋病学组
朱彪
AIDS Group, Society of Tropical Diseases and Parasitology of Zhejiang Medical Association
出处
《中华临床感染病杂志》
CSCD
2019年第2期81-86,106,共7页
Chinese Journal of Clinical Infectious Diseases
关键词
隐球菌病
获得性免疫缺陷综合征
筛查
治疗
共识
Cryptococcosis
Acquired immunodeficiency syndrome
Screening
Treatment
Consensus
作者简介
通信作者:朱彪,浙江大学医学院附属第一医院感染科,传染病诊治国家重点实验室,感染性疾病诊治协同创新中心,310003杭州,Email:zhubiao1207@zju.edu.cn.
