The relentless march of cryptococcal meningitis

• Published in: The Lancet infectious diseases Vol. 17; no. 8; pp. 790 - 791
• Main Author: Williamson, Peter R
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.08.2017; Elsevier Limited
• Subjects: Acquired immune deficiency syndrome; AIDS; Antigenemia; Antiretroviral therapy; Bacteria; Brain; Central nervous system; Children; Clinical trials; Cognition; Cryptococcosis; Disease; Disease control; Drug development; Epidemiology; Estimates; Fungal infections; Fungi; Health risk assessment; Highly active antiretroviral therapy; HIV; Hospitals; Human immunodeficiency virus; Immune system; Immunology; Infections; Infectious Disease; Infectious diseases; Libraries; Macrophages; Meningitis; Mortality; Observational studies; Pandemics; Pathogens; Patients; Population studies; Research facilities; Survival; Viral infections; Virulence; Botswana; Africa; United States > US
• ISSN: 1473-3099; 1474-4457; 1474-4457
• DOI: 10.1016/S1473-3099(17)30245-1

[...]survival and growth of latent fungal organisms within the brain meningeal immune cells might be facilitated by the presence of a latent HIV viral infection, stubbornly persistent within macrophages and the CNS.12 This persistent HIV reservoir, which is postulated to contribute to neurocognitive decline in patients on ART, might thus also have a role in the development of cryptococcal meningitis in patients on ART because fungal macrophage residence is key to survival and virulence of the pathogen.13 Thus, passive approaches to cryptococcal meningitis centred exclusively on HIV treatment might need to be reconsidered. Living Art Enterprises, Llc/Science Photo Library 1 V Pyrgos, AE Seitz, CA Steiner, DR Prevots, PR Williamson, Epidemiology of cryptococcal meningitis in the US: 1997-2009, PloS One, Vol. 8, 2013, e56269 2 RL Castelblanco, M Lee, R Hasbun, Epidemiology of bacterial meningitis in the USA from 1997 to 2010: a population-based observational study, Lancet Infect Dis, Vol. 14, 2014, 813-819 3 BJ Park, KA Wannemuehler, BJ Marston, N Govender, PG Pappas, TM Chiller, Aids, Vol. 23, 2009, 525-530 4 DL Goldman, H Khine, J Abadi, Serologic evidence for Cryptococcus neoformans infection in early childhood, Pediatrics, Vol. 107, 2001, E66 5 S Patel, GY Shin, I Wijewardana, The prevalence of cryptococcal antigenemia in newly diagnosed HIV patients in a Southwest London cohort, J Infect, Vol. 66, 2013, 75-79 6 F Dromer, S Mathoulin-Pelissier, A Fontanet, O Ronin, B Dupont, O Lortholary, Epidemiology of HIV-associated cryptococcosis in France (1985-2001): comparison of the pre- and post-HAART eras, Aids, Vol. 18,...