Do Cerebrospinal Fluid Immune Markers Predict Outcomes in Cryptococcal Meningitis?

Cryptococcal meningitis (CM) remains an important cause of mortality in people with HIV infection in sub-Saharan Africa, with fewer than 50% of patients alive 1 year after diagnosis. The cerebrospinal fluid (CSF) cellular phenotype in CM likely reflects ongoing local immunologic events, and analysis early in infection may predict overall outcome. To explore this, researchers at an HIV clinic in Uganda compared baseline CSF profiles between 18 patients who were alive 1 year after CM diagnosis and 18 who died within 2 weeks of diagnosis. The two groups did not differ in peripheral blood CD4-cell count, percentage receiving antiretroviral therapy, or CSF opening pressure, glucose, protein, or cryptococcal burden.