O-52 Feasibility and impact of rapid diagnostic screening for opportunistic infections among people with advanced HIV disease in Guyana: a prospective multicentre study
Author(s):
T Jagnarine, D Shivdas, L Narain, K Vanccoten, K Prashad, A Jacobs, Q Grant, M Mootoo, N Lawrence, S Siebs, A Camiro
Year of Presentation:
2026
Objective: This study evaluated the feasibility, diagnostic
yield, and early clinical outcomes of rapid diagnostic testing
(RDT) for key opportunistic infections (OIs) among adults
with advanced HIV disease (AHD) in Guyana
Methods: A prospective multicentre cohort study was conducted from February 2024 to March 2025 across seven HIV treatment facilities. Adults ≥18 years with AHD (CD4 <200 cells/mm³ or WHO stage 3/4 illness) underwent pointof-care screening using urinary TB-LAM, serum cryptococcal antigen (CrAg), and urinary Histoplasma antigen RDTs. Participants were followed for 90 days for mortality and loss-to-follow-up. Logistic regression identified predictors of adverse outcomes.
Results: Among 112 participants (median age 38 years; 45% female), 21.4% (24/112) were diagnosed with at least one OI: TB 15.2%, cryptococcosis 6.3%, histoplasmosis 2.7%. One-third of infections occurred in asymptomatic patients. Ninety-nine (88.4%) completed all RDTs, demonstrating operational feasibility. At 90 days, 16.9% experienced an adverse outcome (5.4% deaths, 11.6% lost-to-follow-up). Independent predictors of poor outcome were failure to initiate ART (aOR 18.18, 95% CI 4.04–81.82), hospitalization (aOR 12.79, 95% CI 1.61–101.72), and low haemoglobin (aOR 0.73 per g/dL, 95% CI 0.60–0.89).
Conclusion: Routine rapid screening for OIs among individuals with AHD is feasible and clinically impactful in Guyana. Integrating RDTs into standard HIV care can strengthen early diagnosis, improve ART outcomes, and reduce preventable HIV-related deaths, supporting Guyana’s progress toward HIV Vision 2030.