Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS

  title={Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS},
  author={Benjamin J Park and Kathleen Wannemuehler and Barbara J. Marston and Nelesh P. Govender and Peter G. Pappas and Tom Chiller},
OBJECTIVE Cryptococcal meningitis is one of the most important HIV-related opportunistic infections, especially in the developing world. [] Key MethodMETHODS We used the median incidence rate of available studies in a geographic region to estimate the region-specific cryptococcal meningitis incidence; this was multiplied by the 2007 United Nations Programme on HIV/AIDS HIV population estimate for each region to estimate cryptococcal meningitis cases.
Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis.
Original Research: A medical audit of the management of cryptococcal meningitis in HIV-positive patients
  • Medicine
  • 2012
Despite recent expansion of antiretroviral treatment (ART) programmes in developing countries, Cryptococcal meningitis remains a major opportunistic infection, and a leading cause of mortality in acquired immune deficiency syndrome (AIDS) patients.
Prevalence, correlates, and outcomes of cryptococcal antigen positivity among patients with AIDS, United States, 1986-2012.
The prevalence of cryptococcal infection among advanced AIDS patients in the United States was high and above the published cost-effectiveness threshold for routine screening, and routine CrAg screening among human immunodeficiency virus-infected patients with a CD4 count ≤100 cells/µL is recommended to detect and treat early infection.
High ongoing burden of cryptococcal disease in Africa despite antiretroviral roll out.
The results show that the “treatment gap” is not narrowed, and AIDS-related illness such as cryptococcal meningitis and the associated mortality are not reduced, despite a major effort to expand access to ART throughout sub-Saharan Africa over recent years.
Prevalence and Correlates of Cryptococcal Antigen Positivity Among AIDS Patients — United States, 1986–2012
To quantify the prevalence of undiagnosed cryptococcal infection in HIV-infected persons in the United States during 1986-2012, stored sera from 1,872 participants in the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study with CD4 T-cell counts <100 cells/µL were screened for CrAg, which indicated the overall prevalence of CrAg positivity to be 2.9%.
Cryptococcal meningitis: epidemiology, immunology, diagnosis and therapy
Protective immune responses in HIV-associated cases, immunogenetic predisposition to infection, and the role of immune-mediated pathology in patients with non-HIV associated infection and in the context of HIV- associated immune reconstitution reactions are better understood.
Public Health Importance of Cryptococcal Disease: Epidemiology, Burden, and Control
This chapter focuses primarily on HIV-associated cryptococcosis, due to its much greater public health burden, and discusses the challenges to public health agencies in addressing the threat of
HIV-Associated Cryptococcal Disease in Resource-Limited Settings: A Case for “Prevention Is Better Than Cure”?
Early diagnosis, proactive antifungal therapy with concurrent management of raised intracranial pressure creates the potential to markedly reduce mortality associated with this disease.
Treatment of Cryptococcal Meningitis in KwaZulu-Natal, South Africa
Even in a setting where amphotericin B is available, mortality from cryptococcal meningitis in this setting is high, particularly in the immediate period after diagnosis, which highlights the still unmet need not only for earlier diagnosis of HIV and timely access to treatment of opportunistic infections, but for better treatment strategies.
High Prevalence of Cryptococcal Antigenemia among HIV-infected Patients Receiving Antiretroviral Therapy in Ethiopia
Cryptococcal antigenemia is high in Ethiopia and rapid scale up of screening programs is needed, and Screening should be implemented for HIV-infected patients with low CD4 counts regardless of symptoms or receipt of ART.


Cryptococcal infection in a cohort of HIV-1-infected Ugandan adults
Objective Despite the recognition of Cryptococcus neoformans as a major cause of meningitis in HIV-infected adults in sub-Saharan Africa, little is known about the relative importance of this
Population-based surveillance for cryptococcosis in an antiretroviral-naive South African province with a high HIV seroprevalence
This study demonstrates the high disease burden due to cryptococcosis in an antiretroviral-naive South African population and emphasizes the need to improve early recognition, diagnosis and treatment of the condition.
Cryptococcal meningitis in human immunodeficiency virus-infected patients in Harare, Zimbabwe.
This study provides a unique basis for the development of novel management strategies for patients with cryptococcal meningitis who reside in resource-poor countries.
Bacterial meningitis in Malawian adults: pneumococcal disease is common, severe, and seasonal.
  • S. Gordon, A. Walsh, R. Read
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2000
Despite the HIV-related pattern of infecting pathogens among these cases of meningitis and the increased incidence of the condition, there was evidence that the typical seasonal pattern of pneumococcalMeningitis, which peaks in the cold, dry season, was preserved.
Cryptococcosis: population-based multistate active surveillance and risk factors in human immunodeficiency virus-infected persons. Cryptococcal Active Surveillance Group.
To determine the incidence of cryptococcosis and its risk factors among human immunodeficiency virus (HIV)-infected persons, population-based active surveillance was conducted in four US areas during 1992-1994 and a case-control study was done.
The changing epidemiology of cryptococcosis: an update from population-based active surveillance in 2 large metropolitan areas, 1992-2000.
  • S. Mirza, M. Phelan, R. Hajjeh
  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2003
It is suggested that HIV-infected persons who continue to develop cryptococcosis in the era of highly active antiretroviral therapy (HAART) in the United States are those with limited access to health care and more efforts are needed to expand the availability of HAART and routine HIV care services.
The Impact of HIV on Meningitis as Seen at a South African Academic Hospital (1994 to 1998)
Over a 4-year period the HIV epidemic was responsible for a marked shift in the spectrum of meningitis towards chronic infections such as TB and cryptococcalMeningitis at the PAH.
Clinical and epidemiologic trends in HIV/AIDS patients in a hospital setting of Yaoundé, Cameroon: a 6-year perspective.
Epidemiology and clinical features of HIV infection/AIDS in Korea.
The epidemiological and clinical patterns of HIV infection/AIDS in Korea is investigated by retrospectively analyzing the medical records of 176 HIV-infected persons who visited two major referral hospitals of AIDS in Korea from 1985 to April 2000 to aid in establishing effective preventive measures and treatment guidelines.