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B.Chim 1 , S.P. Soeung 1 , C.H.Veng 1 , S.Thai 1 , L. Lynen 2 , J. van Griensven 1,2

Poster number: TUPDB0102. Integrated Cryptococcal Antigen Screening and Pre-Emptive Treatment prior to Initiation of Antiretroviral Treatment in Cambodia. B.Chim 1 , S.P. Soeung 1 , C.H.Veng 1 , S.Thai 1 , L. Lynen 2 , J. van Griensven 1,2

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B.Chim 1 , S.P. Soeung 1 , C.H.Veng 1 , S.Thai 1 , L. Lynen 2 , J. van Griensven 1,2

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  1. Poster number: TUPDB0102 Integrated Cryptococcal Antigen Screening and Pre-Emptive Treatment prior to Initiation of Antiretroviral Treatment in Cambodia B.Chim1, S.P. Soeung1, C.H.Veng1, S.Thai1, L. Lynen2, J. van Griensven1,2 1 Department of Infectious Diseases, Sihanouk Hospital Center of HOPE, Phnom Penh, Cambodia 2 Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium

  2. Background: • WHO rapid advice on pre-ART “screen and treat” strategy for cryptococcal infection (2010) • Evidence-base on feasibility and effectiveness limited • WHO called for additional research Objectives: Amongst ART-naïve adults with CD4 count <100 cells/µL undergoing pre-ART cryptococcal antigen (sCrAg)-screening to report on 1) prevalence of sCrAg-positivity 2) proportion with concurrent CM 3) six-month treatment outcomes

  3. Methods: - Urban hospital in Cambodia - Screen and treat program since 10/2008 - Retrospective cohort study (10/2008-8/2012) figue1: screening and treatment of cryptococcal meningitis algorithm

  4. Results: • Pts screened pre-ART with CD4 < 100 cells/mL: 357 • sCrAg(+): 30 (8.3%) • Prevalent CM: 6 (20%) - asymptomatic: 2 - minimal symptoms: 4

  5. Conclusion: • Pre-ART “screen-and-treat strategy” • feasible and effective • hospital setting (Cambodia) • Fluconazole - 400 mg/day – might be sufficient for sCrAg(+) pts with CM ruled-out • Consider routine LP (?) • Findings to be confirmed by other studies Acknowledgements:We are grateful to all staff of Infectious diseases department, Sihanouk Hospital, Center of HOPE, Phnom Penh, Cambodia, and to the Institute Tropical Medicine, Antwerp, Belgium and the Belgian DGDC for funding the data collection.

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