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A total of 817 human immunodeficiency virus-infected Ethiopians with CD4 &lt;150 cells/mL underwent plasma cryptococcal antigen (CRAG) screening. CRAG prevalence was 6.2%. Of participants with plasma CRAG titers &gt;1:640, 96% (27 of 28) had cryptococcal meningitis (cerebrospinal fluid CRAG-positive) whereas 50% (7 of 14) with 1:160-1:320 titers had meningitis. With fluconazole 1200 mg/d therapy, 68% of meningitis patients (23 of 34) died within 3 months. Plasma CRAG titers &gt;1:160 predict meningitis, requiring more intensive antifungal therapy.

clinical infectious diseases/clinical infectious diseases (online. university of chicago. press)

Inadequacy of High-Dose Fluconazole Monotherapy Among Cerebrospinal Fluid Cryptococcal Antigen (CrAg)–Positive Human Immunodeficiency Virus-Infected Persons in an Ethiopian CrAg Screening Program