Latar Belakang: Meningitis Cryptococcus merupakan infeksi oportunistik penting pada penderita AIDS dan menduduki urutan ke tiga infeksi otak. Angka kejadian meningitis Cryptococcus secara umum sebesar 957 900 kasus per tahun. Angka kejadian di Indonesia sekitar 5-30%, dan di Jakarta sebesar 21,9%. Angka kejadian tersebut tampaknya belum mencerminkan kondisi sebenarnya, mungkin karena gejala klinis yang tidak khas dan diagnosis pasti memerlukan cairan otak yang sulit didapat. Diperlukan metode lain untuk membantu keputusan klinis saat pungsi lumbal belum dapat dilakukan sehingga prevalensi kriptokokosis yang sesungguhnya diketahui. Tujuan: Mengetahui prevalensi kriptokokosis pada pasien terinfeksi HIV pra ARV di UPT HIV RSCM. Metode penelitian: Studi potong lintang dilakukan sejak Mei - Juli 2013. Subjek penelitian adalah pasien terinfeksi HIV pra ARV. Antigen serum Cryptococcus diperiksa dengan metode lateral flow immunoassay (LFA). Hasil: Dari 78 subjek penelitian, sebanyak 59% adalah laki-laki, berusia 18-68 tahun. Kadar CD4 berkisar antara 2-754 sel/mm3, dan 68% dengan CD4 <200 sel/mm3. Sebanyak lima (6,4%) subjek positif antigen serum Cryptococcus, dua diantaranya dilakukan pungsi lumbal dengan hasil tidak dijumpai Cryptococcus. Kedua subjek ini mendapat terapi flukonazol oral dan hidup sampai saat ini. Tiga subjek lain menolak tatalaksana dan meninggal empat minggu kemudian. Simpulan: Prevalensi kriptokokosis pada pasien terinfeksi HIV pra ARV di UPT HIV-RSCM sebesar 6,4%.

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Background: Cryptococcal meningitis is prominent opportunistic infections occur in PWHIV and seats as the third most frequent brain infection. In general, Meningitis Cryptococcal reach 957 900 cases per year. It is estimated that the prevalence rate is 21.9% and 5 - 30% for Jakarta and Indonesia, respectively. It does not reflect the real number, which might be due to unspecific clinical symptoms. In making diagnosis, it requires cerebrospinal fluid that is challenging to obtain. Other method is needed to feeding clinical decision, when lumbal puncture cannot be performed. Thus, real Cryptococcal prevalence is known.

Aim: To ascertain Cryptococcal prevalence among pre-ART PWHIV at Integrated HIV Clinic, Cipto Mangunkusumo Hospital.

Method: This study using cross-sectional design conducted from May – July 2013 at the HIV clinic. Participants of the study were patients who have not started ART. Cryptococcal serum antigen was tested using LFA.

Results: Of 78 participants, 59% male, age 18 - 68 year old. CD4 countvaried from 2 - 754 cell/mm3, where 68% had CD4 count <200 cell/mm3. Five participants (6.4%) were positive to Cryptococcal serum antigen, whereas two run lumbal puncture which showing negative result for Cryptoccus. They received oral fluconazole treatment and have survived until present. The rest refused thetreatment and passed away four weeks later.

Conclusion: Cryptococcosis prevalence among pre-ART PWHIV at Integrated HIV clinic, Cipto Mangunkusumo Hospital is 6.4%.