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HIV/cryptococcal meningitis co-infection linked to immune reconstitution syndrome
The rate of cryptococcal immune reconstitution syndrome was 16% in patients co-infected with HIV and cryptococcal meningitis, in a study presented here.
Researchers from Bamrasnaradura Infectious Diseases Institute in Thailand conducted a prospective study involving 58 people with HIV who were also diagnosed with cryptococcal meningitis. The aim of the study was to determine the prevalence of systemic or local inflammatory reactions in treatment-naive patients following the introduction of antiretroviral therapy (ART). The study years were 2005 to 2007.
The researchers initiated ART at week six after cryptococcal meningitis diagnosis. They analyzed cerebrospinal fluid at day zero of ART initiation, and then analyzed it again at day 14 and at the time of immune reconstitution syndrome diagnosis.
The researchers performed blood culture for fungus at days zero and seven. They also evaluated CD4 and HIV-1 RNA levels at day zero and at six months following diagnosis of cryptococcal meningitis.
Observation at 14 days revealed that patients with sustained cerebrospinal fluid antigen at high titers following antifungal treatment were at risk for immune reconstitution syndrome.
The researchers wrote that they believe that it is necessary to recognize and manage the phenomenon of immune reconstitution syndrome to achieve favorable outcomes of ART.
Presented at: ICAAC/IDSA joint meeting. Oct. 25-28, 2008. Washington, DC.