| Author | Person, Anna K. | |
| Author | Crabtree-Ramirez, Brenda | |
| Author | Kim, Ahra | |
| Author | Veloso, Valdiléa G. | |
| Author | Maruri, Fernanda | |
| Author | Wandeler, Gilles | |
| Author | Fox, Matthew | |
| Author | Moore, Richard | |
| Author | Gill, M. John | |
| Author | Imran, Darma | |
| Author | Nguyen, Kinh Van | |
| Author | Nalitya, Elizabeth | |
| Author | Muyindike, Winnie | |
| Author | Shepherd, Bryan E. | |
| Author | McGowan, Catherine C. | |
| Access date | 2023-08-02T13:40:10Z | |
| Available date | 2023-08-02T13:40:10Z | |
| Document date | 2023 | |
| Citation | PERSON, Anna K. et al. Cryptococcal Meningitis and Clinical Outcomes in Persons With Human Immunodeficiency Virus: A Global View. Clinical Infectious Diseases, v. 76, n. 12, p. 2116-2125, Jun. 2023. | en_US |
| ISSN | 1058-4838 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/59876 | |
| Sponsorship | The International Epidemiology Databases to Evaluate AIDS is supported by the National Institutes of Health’s (NIH’s) National Institute of Allergy and Infectious Diseases; the Eunice Kennedy Shriver National Institute of Child Health and Human Development; the National Cancer Institute; the National Institute of Mental Health; the National Institute on Drug Abuse; the National Heart, Lung, and Blood Institute; the National Institute on Alcohol Abuse and Alcoholism; the National Institute of Diabetes and Digestive and Kidney Diseases; and the Fogarty International Center: Asia-Pacific, U01AI069907; Caribbean, Central and South America network for HIV epidemiology (CCASAnet), U01AI069923 (A. K. P. is listed as an investigator); East Africa,
U01AI069911; North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), U01AI069918; Southern Africa, U01AI069924. Informatics resources are supported by the Harmonist Project, R24AI24872. REDCap support was provided by UL1 TR000445 from National Center for Advancing Translational Sciences (NCATS)/NIH. | en_US |
| Language | eng | en_US |
| Publisher | The University of Chicago Press | en_US |
| Rights | restricted access | |
| Title | Cryptococcal Meningitis and Clinical Outcomes in Persons With Human Immunodeficiency Virus: A Global View | en_US |
| Type | Article | |
| DOI | 10.1093/cid/ciad076 | |
| Abstract | Background: Cryptococcal meningitis (CM) is a major cause of morbidity and mortality in persons with human immunodeficiency virus (HIV; PWH). Little is known about CM outcomes and availability of diagnostic and treatment modalities globally. Methods: In this retrospective cohort study, we investigated CM incidence and all-cause mortality in PWH in the International Epidemiology Databases to Evaluate AIDS cohort from 1996 to 2017. We estimated incidence using quasi-Poisson models adjusted for sex, age, calendar year, CD4 cell count (CD4), and antiretroviral therapy (ART) status. Mortality after CM diagnosis was examined using multivariable Cox models. A site survey from 2017 assessed availability of CM diagnostic and treatment modalities. Results: Among 518 852 PWH, there were 3857 cases of CM with an estimated incidence of 1.54 per 1000 person-years. Mortality over a median of 2.6 years of post-CM diagnosis follow-up was 31.6%, with 29% lost to follow-up. In total, 2478 (64%) were diagnosed with CM after ART start with a median of 253 days from ART start to CM diagnosis. Older age (hazard [HR], 1.31 for 50 vs 35 years), lower CD4 (HR, 1.15 for 200 vs 350 cells/mm3), and earlier year of CM diagnosis (HR, 0.51 for 2015 vs 2000) were associated with higher mortality. Of 89 sites, 34% reported access to amphotericin B; 12% had access to flucytosine. Conclusions: Mortality after CM diagnosis was high. A substantial portion of CM cases occurred after ART start, though incidence and mortality may be higher than reported due to ascertainment bias. Many sites lacked access to recommended CM treatment. | en_US |
| Affilliation | Division of Infectious Diseases. Vanderbilt University Medical Center. Nashville, Tennessee, USA. | en_US |
| Affilliation | Departamento de Infectología. Instituto Nacional de Ciencias Médicas y Nutrición. Mexico City, Mexico. | en_US |
| Affilliation | Department of Biostatistics. Vanderbilt University Medical Center. Nashville, Tennessee, USA. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Division of Infectious Diseases. Vanderbilt University Medical Center. Nashville, Tennessee, USA. | en_US |
| Affilliation | Department of Infectious Diseases. Bern University Hospital. University of Bern. Bern, Switzerland. | en_US |
| Affilliation | Department of Global Health. Boston University. Boston, Massachusetts, USA. | en_US |
| Affilliation | Center for Global Health. Johns Hopkins University. Baltimore, Maryland, USA. | en_US |
| Affilliation | Department of Medicine. University of Calgary. Calgary, Alberta, Canada. | en_US |
| Affilliation | Cipto Mangunkusumo Hospital. Jakarta, Indonesia. | en_US |
| Affilliation | National Hospital of Tropical Diseases. Hanoi, Viet Nam. | en_US |
| Affilliation | Infectious Diseases Institute. College of Health Sciences. Makerere University. Kampala, Uganda. | en_US |
| Affilliation | Department of Internal Medicine. Mbarara University of Science and Technology and Mbarara Regional Referral Hospital. Mbarara, Uganda. | en_US |
| Affilliation | Department of Biostatistics. Vanderbilt University Medical Center. Nashville, Tennessee, USA. | en_US |
| Affilliation | Division of Infectious Diseases. Vanderbilt University Medical Center. Nashville, Tennessee, USA. | en_US |
| Subject | AIDS | en_US |
| Subject | HIV | en_US |
| Subject | Cryptococcal meningitis | en_US |
| Subject | Global health | en_US |
| e-ISSN | 1537-6591 | |
| Embargo date | 2030-12-31 | |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |
