Survival time of HIV-infected patients with cryptococcal meningitis.

To study survival time and risk factors of mortality among HIV-infected patients who had cryptococcal meningitis.
Retrospective cohort study.
Patients' medical records of those who had HIV-infection with newly diagnosed cryptoccocal meningitis between January 2002 and December 2004 were reviewed. Each patient was classified into one of two groups, according to their anti-retroviral status (ART).
Five hundred and forty nine patients enrolled in the present study: 281 (51.2%) in the ART+ group and 268 (48.8%) in the ART-group. The mean age was 33.4 +/- 6.9 years old in the ART + group and 33.6 +/- 7.0 years old in the ART-group. There were more male in both groups: 207 males and 74 females in the ART+ group, and 195 males and 73 females in the ART-group. Baseline CD4 cell count of both groups was 20 (6-74) cells/mL and 24 (9-72) cells/ml. About 30% of both groups of patients experienced major opportunistic infection before cryptococcal meningitis. All patients were treated by standard amphotericin B for a 2-week duration followed by fluconazole for an additional 8 weeks. There were no differences of baseline characteristics between the two groups (p > 0.05). The survival rates at 12, 24, and 36 months were 92.8%, 87.4%, and 85.4% in the ART+ group and 55.3%, 42.2%, and 36.8% in the ART- group, respectively (p < 0.01). The median survival time in the ART- group was 15 months. From the Cox regression model, the hazard ratio for "not received ART" was 4.87 (95%CI = 2.48-9.44, p < 0.01).
The present study demonstrated the substantial increasing of survival time of HIV-infected patients with cryptococcal meningitis by initiated ART even in a resource limited setting (no flucytosine, local combined antiretroviral drugs with NVP based regimens).
AuthorsSuthat Chottanapund, Pratap Singhasivanon, Jaranit Kaewkungwal, Kanittha Chamroonswasdi, Weerawat Manosuthi
JournalJournal of the Medical Association of Thailand = Chotmaihet thangphaet (J Med Assoc Thai) Vol. 90 Issue 10 Pg. 2104-11 (Oct 2007) ISSN: 0125-2208 [Print] Thailand
PMID18041430 (Publication Type: Journal Article)
Chemical References
  • Anti-Bacterial Agents
  • Amphotericin B
  • Fluconazole
  • Adult
  • Amphotericin B (therapeutic use)
  • Anti-Bacterial Agents (therapeutic use)
  • CD4 Lymphocyte Count
  • Comorbidity
  • Female
  • Fluconazole (therapeutic use)
  • HIV Infections (drug therapy, mortality)
  • Humans
  • Male
  • Meningitis, Cryptococcal (drug therapy, mortality)
  • Retrospective Studies
  • Risk Factors
  • Survival
  • Time Factors

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!

Choose Username:
Verify Password: