PDF(Pubmed)
Abstract：
BACKGROUND: The incidence of cryptococcosis amongst HIV-negative persons is increasing. Whilst the excellent performance of the CrAg testing in people living with HIV is well described, the diagnostic performance of the CrAg LFA has not been systematically evaluated in HIV-negative cohorts on serum or cerebrospinal fluid.
METHODS: We performed a systematic review to characterise the diagnostic performance of IMMY CrAg® LFA in HIV-negative populations on serum and cerebrospinal fluid. A systematic electronic search was performed using Medline, Embase, Global Health, CENTRAL, WoS Science Citation Index, SCOPUS, Africa-Wide Information, LILACS and WHO Global Health Library. Studies were screened and data extracted from eligible studies by two independent reviewers. A fixed effect meta-analysis was used to estimate the diagnostic sensitivity and specificity.
RESULTS: Of 447 records assessed for eligibility, nine studies met our inclusion criteria, including 528 participants overall. Amongst eight studies that evaluated the diagnostic performance of the IMMY CrAg® LFA on serum, the pooled median sensitivity was 96% (95% Credible Interval (CrI) 68-100%) with a pooled specificity estimate of 96% (95%CrI 84-100%). Amongst six studies which evaluated the diagnostic performance of IMMY CrAg® LFA on CSF, the pooled median sensitivity was 99% (95%CrI 95-100%) with a pooled specificity median of 99% (95%CrI 95-100%).
CONCLUSIONS: This review demonstrates a high pooled sensitivity and specificity for the IMMY CrAg® LFA in HIV-negative populations, in keeping with findings in HIV-positive individuals. The review was limited by the small number of studies. Further studies using IMMY CrAg® LFA in HIV-negative populations would help to better determine the diagnostic value of this test.
METHODS: We performed a systematic review to characterise the diagnostic performance of IMMY CrAg® LFA in HIV-negative populations on serum and cerebrospinal fluid. A systematic electronic search was performed using Medline, Embase, Global Health, CENTRAL, WoS Science Citation Index, SCOPUS, Africa-Wide Information, LILACS and WHO Global Health Library. Studies were screened and data extracted from eligible studies by two independent reviewers. A fixed effect meta-analysis was used to estimate the diagnostic sensitivity and specificity.
RESULTS: Of 447 records assessed for eligibility, nine studies met our inclusion criteria, including 528 participants overall. Amongst eight studies that evaluated the diagnostic performance of the IMMY CrAg® LFA on serum, the pooled median sensitivity was 96% (95% Credible Interval (CrI) 68-100%) with a pooled specificity estimate of 96% (95%CrI 84-100%). Amongst six studies which evaluated the diagnostic performance of IMMY CrAg® LFA on CSF, the pooled median sensitivity was 99% (95%CrI 95-100%) with a pooled specificity median of 99% (95%CrI 95-100%).
CONCLUSIONS: This review demonstrates a high pooled sensitivity and specificity for the IMMY CrAg® LFA in HIV-negative populations, in keeping with findings in HIV-positive individuals. The review was limited by the small number of studies. Further studies using IMMY CrAg® LFA in HIV-negative populations would help to better determine the diagnostic value of this test.
摘要：
背景：HIV阴性人群中隐球菌病的发病率正在增加。虽然CrAg检测在艾滋病毒感染者中的优异性能得到了很好的描述，CrAgLFA的诊断性能尚未在HIV阴性队列中对血清或脑脊液进行系统评估.
方法：我们进行了系统评价，以描述IMMYCrAg®LFA在HIV阴性人群血清和脑脊液中的诊断性能。使用Medline进行了系统的电子搜索，Embase,全球卫生,中部,WoS科学引文索引,Scopus,非洲信息，LILACS和世卫组织全球卫生图书馆。由两名独立的审阅者筛选研究并从符合条件的研究中提取数据。固定效应荟萃分析用于评估诊断敏感性和特异性。
结果：在评估资格的447条记录中，九项研究符合我们的纳入标准，总共有528名参与者。在评估IMMYCrAg®LFA对血清的诊断性能的八项研究中，合并的中位敏感性为96%(95%可信区间(CrI)68-100%),合并的特异性估计值为96%(95%CrI84-100%).在评估IMMYCrAg®LFA对CSF的诊断性能的六项研究中，合并的中位敏感性为99%(95%CrI95-100%),合并的中位特异性为99%(95%CrI95-100%).
结论：本综述证明了IMMYCrAg®LFA在HIV阴性人群中具有较高的集合敏感性和特异性，与HIV阳性个体的研究结果一致。该综述受到研究数量少的限制。在HIV阴性人群中使用IMMYCrAg®LFA的进一步研究将有助于更好地确定该测试的诊断价值。
方法：我们进行了系统评价，以描述IMMYCrAg®LFA在HIV阴性人群血清和脑脊液中的诊断性能。使用Medline进行了系统的电子搜索，Embase,全球卫生,中部,WoS科学引文索引,Scopus,非洲信息，LILACS和世卫组织全球卫生图书馆。由两名独立的审阅者筛选研究并从符合条件的研究中提取数据。固定效应荟萃分析用于评估诊断敏感性和特异性。
结果：在评估资格的447条记录中，九项研究符合我们的纳入标准，总共有528名参与者。在评估IMMYCrAg®LFA对血清的诊断性能的八项研究中，合并的中位敏感性为96%(95%可信区间(CrI)68-100%),合并的特异性估计值为96%(95%CrI84-100%).在评估IMMYCrAg®LFA对CSF的诊断性能的六项研究中，合并的中位敏感性为99%(95%CrI95-100%),合并的中位特异性为99%(95%CrI95-100%).
结论：本综述证明了IMMYCrAg®LFA在HIV阴性人群中具有较高的集合敏感性和特异性，与HIV阳性个体的研究结果一致。该综述受到研究数量少的限制。在HIV阴性人群中使用IMMYCrAg®LFA的进一步研究将有助于更好地确定该测试的诊断价值。
