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- Title
Long-term Mortality and Disability in Cryptococcal Meningitis: A Systematic Literature Review.
- Authors
Pasquier, Estelle; Kunda, John; Beaudrap, Pierre De; Loyse, Angela; Temfack, Elvis; Molloy, Síle F; Harrison, Thomas S; Lortholary, Olivier
- Abstract
Cryptococcal meningitis (CM) is the primary cause of meningitis in adults with human immunodeficiency virus (HIV) infection and an emerging disease in HIV-seronegative individuals. No literature review has studied the long-term outcome of CM. We performed a systematic review on the long-term (≥3-month) impact of CM (Cryptococcus neoformans and Cryptococcus gattii) on mortality and disability in HIV-infected and non--HIV-infected adults. Although the quality of current evidence is limited, the long-term impact of CM on survival and disability seems to be high. One-year mortality ranged from 13% in an Australian non--HIV-infected C. gattii--infected cohort to 78% in a Malawian HIV-infected cohort treated with fluconazole monotherapy. One-year impairment proportions among survivors ranged from 19% in an Australian C. gattii cohort to >70% in a Taiwanese non--HIV- and HIV-infected cohorts. Ongoing early therapeutic interventions, early detection of impairments and access to rehabilitation services may significantly improve patients' survival and quality of life.
- Subjects
AUSTRALIA; MALAWI; TAIWAN; FLUCONAZOLE; CRYPTOCOCCUS neoformans; ETHNIC groups; HEALTH services accessibility; PSYCHOLOGY of HIV-positive persons; LONGITUDINAL method; MENINGITIS; PEOPLE with disabilities; QUALITY of life; SURVIVAL; SYSTEMATIC reviews; EARLY medical intervention; PROGNOSIS; THERAPEUTICS
- Publication
Clinical Infectious Diseases, 2018, Vol 66, Issue 7, p1122
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/cix870