Mortality in HIV-Infected Patients with Cryptococcal Meningitis

Factors independently associated with higher risk for death included mental status changes, high CSF fungal burden, slow clearance of infection, and use of fluconazole for initial treatment.

Cryptococcal meningitis (CM) remains a common, life-threatening infection in HIV-infected individuals in many world regions despite increasing availability of antiretroviral therapy (ART) and antifungal medications. Researchers recently explored factors associated with mortality in nine trials among HIV-infected patients with CM in Africa and Asia. All trials used early fungicidal activity (i.e., rate of decrease in cerebrospinal fluid [CSF]) cryptococcal log colony–forming units/mL) as the primary outcome.

The study involved 501 ART-naive patients with first-episode CM (median age, 34; 52% male; median CD4 count, 23 cells/mm³). Induction treatment for CM was amphotericin B in 80% and fluconazole in 20%; all-cause mortality was 17% at 2 week…

Reviewing Author

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

Mortality in HIV-Infected Patients with Cryptococcal Meningitis

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Reviewing Author