A retrospective study of AIDS-associated cryptomeningitis

Ravinder Kaur Sachdeva, Shivani Randev, Aman Sharma, Ajay Wanchu, Arunaloke Chakrabarti, Surjit Singh, Subhash Varma

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Cryptococcal meningitis has emerged as a leading cause of infectious morbidity and mortality in patients with AIDS. A retrospective analysis of records of HIV-infected individuals registered in the Immunodeficiency Clinic of a tertiary care hospital and research institute was carried out. Records of 6900 HIV-infected individuals who were enrolled in the clinic between January 2002 and March 2011 were analyzed. Records of 6900 HIV-infected individuals were screened. Ninety-one were diagnosed with cryptococcal meningitis (1.32%). In 68 individuals cryptococcal meningitis was the presenting illness. Nine patients developed meningitis within 6 months of starting antiretroviral treatment (ART). Six patients were receiving ART for more than 6 months at the time of diagnosis. The remaining eight patients were not on ART at the time of development of meningitis. The mean baseline CD4 count of patients was 77.7±61 (range, 4-259, n=91) cells/mm3. Seventy-four patients had a CD4 value of less than 100 at the time of diagnosis of cryptococcal meningitis. Eleven of these ninety-one patients had a relapse of cryptococcal meningitis while receiving a maintenance dose of fluconazole. During follow-up 37 died, two were lost to follow-up, while 52 patients were on regular ART. Mortality due to cryptococcal meningitis amounted to 0.54% (37/6900). There was no correlation between survival and duration of ART at the time of cryptomeningitis (Pearsons χ2=0.241, p=0.884). There was a significant difference in the CD4 counts of the HIV-infected individuals who died with cryptomeningitis and those who survived (Pearson's χ2=9.1, df=4, p=0.05). The frequency of cryptococcal meningitis was 1.32%. Cryptococcal meningitis leads to high mortality in HIV patients. Management of cryptococcal infection remains a key facet of AIDS care in India.

Original languageEnglish (US)
Pages (from-to)1220-1226
Number of pages7
JournalAIDS Research and Human Retroviruses
Volume28
Issue number10
DOIs
StatePublished - Oct 1 2012

ASJC Scopus subject areas

  • Immunology
  • Virology
  • Infectious Diseases

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    Sachdeva, R. K., Randev, S., Sharma, A., Wanchu, A., Chakrabarti, A., Singh, S., & Varma, S. (2012). A retrospective study of AIDS-associated cryptomeningitis. AIDS Research and Human Retroviruses, 28(10), 1220-1226. https://doi.org/10.1089/aid.2011.0293