Outcome of HIV-1-associated cryptococcal meningitis, Denmark 1988-2008
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Outcome of HIV-1-associated cryptococcal meningitis, Denmark 1988-2008. / Mathiesen, Inger Hee Mabuza; Knudsen, Jenny Dahl; Gerstoft, Jan; Cowan, Susan; Benfield, Thomas Lars Vibe.
In: Scandinavian Journal of Infectious Diseases, Vol. 44, No. 3, 2012, p. 197-200 .Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Outcome of HIV-1-associated cryptococcal meningitis, Denmark 1988-2008
AU - Mathiesen, Inger Hee Mabuza
AU - Knudsen, Jenny Dahl
AU - Gerstoft, Jan
AU - Cowan, Susan
AU - Benfield, Thomas Lars Vibe
PY - 2012
Y1 - 2012
N2 - Abstract Introduction: The risk of HIV-1-associated Cryptococcus neoformans meningitis (CM) has decreased and the outcome has improved with the use of combination antiretroviral therapy (cART). Outcome has not been reported in Denmark in the cART era. Methods: A review of all cases of HIV-1-associated CM treated at 2 hospitals in Denmark was carried out. Survival was compared by time-updated Cox proportional hazards analysis. Results: A total of 45 cases were evaluated. Six individuals (13.3%) died within 30 days of being diagnosed with CM. cART was initiated a median of 15 days (range 3?53) after a diagnosis of CM for 12 individuals and did not affect 30-day outcome. Older age, however, was associated with an increased risk of death at 30 days (mortality rate ratio (MMR) 1.16 (95% confidence interval (95% CI) 1.05?1.30) per y increment). Twenty-four (55.8%) of 43 individuals (2 had emigrated) died within the 1(st) y. Initiation of cART significantly improved 1-y outcome (MMR 0.22, 95% CI 0.06?0.77). Mental status, CD4 T cell count, and antifungal did not affect short- or long-term outcome. Conclusions: We found that long-term survival after HIV-1-associated CM has improved significantly with the use of cART. Short-term mortality was not affected by initiation of cART and remained high.
AB - Abstract Introduction: The risk of HIV-1-associated Cryptococcus neoformans meningitis (CM) has decreased and the outcome has improved with the use of combination antiretroviral therapy (cART). Outcome has not been reported in Denmark in the cART era. Methods: A review of all cases of HIV-1-associated CM treated at 2 hospitals in Denmark was carried out. Survival was compared by time-updated Cox proportional hazards analysis. Results: A total of 45 cases were evaluated. Six individuals (13.3%) died within 30 days of being diagnosed with CM. cART was initiated a median of 15 days (range 3?53) after a diagnosis of CM for 12 individuals and did not affect 30-day outcome. Older age, however, was associated with an increased risk of death at 30 days (mortality rate ratio (MMR) 1.16 (95% confidence interval (95% CI) 1.05?1.30) per y increment). Twenty-four (55.8%) of 43 individuals (2 had emigrated) died within the 1(st) y. Initiation of cART significantly improved 1-y outcome (MMR 0.22, 95% CI 0.06?0.77). Mental status, CD4 T cell count, and antifungal did not affect short- or long-term outcome. Conclusions: We found that long-term survival after HIV-1-associated CM has improved significantly with the use of cART. Short-term mortality was not affected by initiation of cART and remained high.
U2 - 10.3109/00365548.2011.611168
DO - 10.3109/00365548.2011.611168
M3 - Journal article
C2 - 22077922
VL - 44
SP - 197
EP - 200
JO - Infectious Diseases
JF - Infectious Diseases
SN - 2374-4235
IS - 3
ER -
ID: 35460447