Clinical Utility of Monitoring Serum Cryptococcal Antigen (sCRAG) Titers in Patients with AIDS-Related Cryptococcal Disease [Abert JA, et al. HIV Clin Trials 2000; 1: 1]:The authors from San Francisco General performed a retrospective analysis of 314 patients with HIV and cryptococcosis to determine the utility of monitoring serum cryptococcal antigen titers. No changes were noted in 12 (9%), an increase was noted in six (4%) and a decrease was noted in 118 (87%). Analysis of the association of serum titers to time of relapse showed no correlation. The authors concluded that it is not useful to measure serum cryptococcal antigen titers as a component of managing cryptococcal infections in AIDS patients.
Comment: This is the lead article in the launch issue of HIV Clinical Trials, and it is a good one, which addresses an important clinical issue. The utility of cryptococcal antigen titers in blood and CSF have been the subject of substantial controversy for several years. This report convincingly shows that sequential monitoring of these levels has little clinical value. posted 8/31/2000