Our study performed in a French University Centre confirms the sensitivity of the test whether testing sera or CSF. However, one should note that most of the patients, who tested positive in our study, were HIV-positive, thus additional studies may be required to extend the results to other kinds of populations at risk of cryptococcosis.
Nevertheless, it was interesting to note that, even in the case of a very low concentration of antigen as judged on the titration performed with the latex assay, the LFA returned a positive result. Indeed, the LFA was found positive while the EIA test remained negative in 2 sera from a patient with low antigen titration.
This may correspond to subclinical forms whose diagnosis may be anticipated with the most sensitive test.9 Indeed, while progressive meningitis remains the main clinical presentation, the routine use of systematic screening for antigenic detection in serum has shown that subclinical, such as isolated low-grade of fever or even asymptomatic, forms are common,10 and must be diagnosed to prevent their evolution towards more severe forms.