Long term 5-year survival of persons with cryptococcal meningitis or asymptomatic subclinical antigenemia in Uganda
Data presented previously as an abstract at the 2011 CUGH Global Health Conference in Montreal, Canada on 15 Nov 2011. The long-term survival of HIV-infected persons with symptomatic cryptococcal meningitis and asymptomatic, subclinical cryptococcal antigenemia (CRAG+) is unknown. We prospectively e...
Gespeichert in:
| Veröffentlicht in: | PloS one 2012-12, Vol.7 (12), p.e51291-e51291 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e51291 |
|---|---|
| container_issue | 12 |
| container_start_page | e51291 |
| container_title | PloS one |
| container_volume | 7 |
| creator | Butler, Elissa K Boulware, David R Bohjanen, Paul R Meya, David B |
| description | Data presented previously as an abstract at the 2011 CUGH Global Health Conference in Montreal, Canada on 15 Nov 2011. The long-term survival of HIV-infected persons with symptomatic cryptococcal meningitis and asymptomatic, subclinical cryptococcal antigenemia (CRAG+) is unknown. We prospectively enrolled 25 asymptomatic, antiretroviral therapy (ART)-naïve CRAG+ Ugandans with CD488%), demonstrating that long term survival is possible in resource-limited settings. Pre-ART CRAG screening with preemptive fluconazole treatment and improved CM treatment(s) are needed to reduce AIDS-attributable mortality due to cryptococcosis which remains 20-25% in sub-Saharan Africa. |
| doi_str_mv | 10.1371/journal.pone.0051291 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1970861421</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A477084081</galeid><doaj_id>oai_doaj_org_article_c2595b37571c40588ce57523b6966426</doaj_id><sourcerecordid>A477084081</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-a89a2a078453c3bc59c4612b9f750e5a2ef52e6c2eaf4cd669efe0f3e64339043</originalsourceid><addsrcrecordid>eNqNk1uL1DAUx4so7rr6DUQLgujDjLk0afMiLIuXgYEFdX0Naea0k6FNZpN0dL69Gae7TGUfJA8JOb_zT84ty15iNMe0xB82bvBWdfOtszBHiGEi8KPsHAtKZpwg-vjkfJY9C2GTIFpx_jQ7I5QwXFTsPAtLZ9s8gu9zNtuD8nkY_M7sVJe7Jt-CD86G_JeJ61z7_TY67bROxh6ssa2JJuTO5yrs-2TrVTQ6CdS6M9YcMGWjacFCb1RubH7TKrtSz7MnjeoCvBj3i-zm86cfV19ny-svi6vL5UxzQeJMVUIRhcqqYFTTWjOhC45JLZqSIWCKQMMIcE1ANYVecS6gAdRQ4AWlAhX0Int91N12LsgxX0FiUaKK44LgRCyOxMqpjdx60yu_l04Z-ffC-VYqn2LqQGrCBKtpyUqsC8SqSgMrGaE1F5wXhCetj-NrQ93DSoONXnUT0anFmrVs3U5ShgWrSBJ4Nwp4dztAiLI3QUPXKQtuSP8mJaWoxJQl9M0_6MPRjVSrUgDGNi69qw-i8rIoE1ag6kDNH6DSWqWq6dRcjUn3E4f3E4fERPgdWzWEIBffv_0_e_1zyr49YdegurgOrhuiSS04BYsjqL0LwUNzn2SM5GE27rIhD7Mhx9lIbq9OC3TvdDcM9A_cbQnG</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1970861421</pqid></control><display><type>article</type><title>Long term 5-year survival of persons with cryptococcal meningitis or asymptomatic subclinical antigenemia in Uganda</title><source>MEDLINE</source><source>TestCollectionTL3OpenAccess</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><source>Public Library of Science (PLoS)</source><creator>Butler, Elissa K ; Boulware, David R ; Bohjanen, Paul R ; Meya, David B</creator><contributor>Cameron, D. William</contributor><creatorcontrib>Butler, Elissa K ; Boulware, David R ; Bohjanen, Paul R ; Meya, David B ; Cameron, D. William</creatorcontrib><description>Data presented previously as an abstract at the 2011 CUGH Global Health Conference in Montreal, Canada on 15 Nov 2011. The long-term survival of HIV-infected persons with symptomatic cryptococcal meningitis and asymptomatic, subclinical cryptococcal antigenemia (CRAG+) is unknown. We prospectively enrolled 25 asymptomatic, antiretroviral therapy (ART)-naïve CRAG+ Ugandans with CD4<100 cells/mcL who received pre-emptive fluconazole treatment (CRAG+ cohort) and 189 ART-naïve Ugandans with symptomatic cryptococcal meningitis treated with amphotericin (CM cohort). The 10-week survival was 84% (95%CI: 70-98%) in the CRAG+ cohort and 57% (95%CI: 50%-64%) in the CM cohort. The CRAG+ cohort had improved five-year survival of 76% (95%CI: 59%-93%) compared to 42% (95%CI: 35%-50%) in the CM cohort (P = 0.001). The two cohorts had similar immunosuppression pre-ART with median CD4 counts of 15 vs. 21 CD4/mcL in the CRAG+ and CM cohorts, respectively (P = 0.45). Despite substantial early mortality, subsequent 5-year survival of persons surviving 6-months was excellent (>88%), demonstrating that long term survival is possible in resource-limited settings. Pre-ART CRAG screening with preemptive fluconazole treatment and improved CM treatment(s) are needed to reduce AIDS-attributable mortality due to cryptococcosis which remains 20-25% in sub-Saharan Africa.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0051291</identifier><identifier>PMID: 23251485</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adult ; AIDS ; Antigenemia ; Antigens ; Antigens, Fungal - blood ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; CD4 antigen ; Clinical trials ; Cohort Studies ; Cryptococcal meningitis ; Cryptococcosis ; Drug dosages ; Drug therapy ; Female ; Fluconazole ; Fungal infections ; Global health ; Health aspects ; Highly active antiretroviral therapy ; HIV ; Human immunodeficiency virus ; Humans ; Immunosuppression ; Infections ; Infectious diseases ; Male ; Medicine ; Meningitis ; Meningitis, Cryptococcal - immunology ; Meningitis, Cryptococcal - physiopathology ; Middle Aged ; Mortality ; Preempting ; Survival ; Survival Analysis ; Uganda</subject><ispartof>PloS one, 2012-12, Vol.7 (12), p.e51291-e51291</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>2012 Butler et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2012 Butler et al 2012 Butler et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-a89a2a078453c3bc59c4612b9f750e5a2ef52e6c2eaf4cd669efe0f3e64339043</citedby><cites>FETCH-LOGICAL-c692t-a89a2a078453c3bc59c4612b9f750e5a2ef52e6c2eaf4cd669efe0f3e64339043</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519582/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519582/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23847,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23251485$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Cameron, D. William</contributor><creatorcontrib>Butler, Elissa K</creatorcontrib><creatorcontrib>Boulware, David R</creatorcontrib><creatorcontrib>Bohjanen, Paul R</creatorcontrib><creatorcontrib>Meya, David B</creatorcontrib><title>Long term 5-year survival of persons with cryptococcal meningitis or asymptomatic subclinical antigenemia in Uganda</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Data presented previously as an abstract at the 2011 CUGH Global Health Conference in Montreal, Canada on 15 Nov 2011. The long-term survival of HIV-infected persons with symptomatic cryptococcal meningitis and asymptomatic, subclinical cryptococcal antigenemia (CRAG+) is unknown. We prospectively enrolled 25 asymptomatic, antiretroviral therapy (ART)-naïve CRAG+ Ugandans with CD4<100 cells/mcL who received pre-emptive fluconazole treatment (CRAG+ cohort) and 189 ART-naïve Ugandans with symptomatic cryptococcal meningitis treated with amphotericin (CM cohort). The 10-week survival was 84% (95%CI: 70-98%) in the CRAG+ cohort and 57% (95%CI: 50%-64%) in the CM cohort. The CRAG+ cohort had improved five-year survival of 76% (95%CI: 59%-93%) compared to 42% (95%CI: 35%-50%) in the CM cohort (P = 0.001). The two cohorts had similar immunosuppression pre-ART with median CD4 counts of 15 vs. 21 CD4/mcL in the CRAG+ and CM cohorts, respectively (P = 0.45). Despite substantial early mortality, subsequent 5-year survival of persons surviving 6-months was excellent (>88%), demonstrating that long term survival is possible in resource-limited settings. Pre-ART CRAG screening with preemptive fluconazole treatment and improved CM treatment(s) are needed to reduce AIDS-attributable mortality due to cryptococcosis which remains 20-25% in sub-Saharan Africa.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>AIDS</subject><subject>Antigenemia</subject><subject>Antigens</subject><subject>Antigens, Fungal - blood</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>CD4 antigen</subject><subject>Clinical trials</subject><subject>Cohort Studies</subject><subject>Cryptococcal meningitis</subject><subject>Cryptococcosis</subject><subject>Drug dosages</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Fluconazole</subject><subject>Fungal infections</subject><subject>Global health</subject><subject>Health aspects</subject><subject>Highly active antiretroviral therapy</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immunosuppression</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medicine</subject><subject>Meningitis</subject><subject>Meningitis, Cryptococcal - immunology</subject><subject>Meningitis, Cryptococcal - physiopathology</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Preempting</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Uganda</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1uL1DAUx4so7rr6DUQLgujDjLk0afMiLIuXgYEFdX0Naea0k6FNZpN0dL69Gae7TGUfJA8JOb_zT84ty15iNMe0xB82bvBWdfOtszBHiGEi8KPsHAtKZpwg-vjkfJY9C2GTIFpx_jQ7I5QwXFTsPAtLZ9s8gu9zNtuD8nkY_M7sVJe7Jt-CD86G_JeJ61z7_TY67bROxh6ssa2JJuTO5yrs-2TrVTQ6CdS6M9YcMGWjacFCb1RubH7TKrtSz7MnjeoCvBj3i-zm86cfV19ny-svi6vL5UxzQeJMVUIRhcqqYFTTWjOhC45JLZqSIWCKQMMIcE1ANYVecS6gAdRQ4AWlAhX0Int91N12LsgxX0FiUaKK44LgRCyOxMqpjdx60yu_l04Z-ffC-VYqn2LqQGrCBKtpyUqsC8SqSgMrGaE1F5wXhCetj-NrQ93DSoONXnUT0anFmrVs3U5ShgWrSBJ4Nwp4dztAiLI3QUPXKQtuSP8mJaWoxJQl9M0_6MPRjVSrUgDGNi69qw-i8rIoE1ag6kDNH6DSWqWq6dRcjUn3E4f3E4fERPgdWzWEIBffv_0_e_1zyr49YdegurgOrhuiSS04BYsjqL0LwUNzn2SM5GE27rIhD7Mhx9lIbq9OC3TvdDcM9A_cbQnG</recordid><startdate>20121210</startdate><enddate>20121210</enddate><creator>Butler, Elissa K</creator><creator>Boulware, David R</creator><creator>Bohjanen, Paul R</creator><creator>Meya, David B</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20121210</creationdate><title>Long term 5-year survival of persons with cryptococcal meningitis or asymptomatic subclinical antigenemia in Uganda</title><author>Butler, Elissa K ; Boulware, David R ; Bohjanen, Paul R ; Meya, David B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-a89a2a078453c3bc59c4612b9f750e5a2ef52e6c2eaf4cd669efe0f3e64339043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adult</topic><topic>AIDS</topic><topic>Antigenemia</topic><topic>Antigens</topic><topic>Antigens, Fungal - blood</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>CD4 antigen</topic><topic>Clinical trials</topic><topic>Cohort Studies</topic><topic>Cryptococcal meningitis</topic><topic>Cryptococcosis</topic><topic>Drug dosages</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Fluconazole</topic><topic>Fungal infections</topic><topic>Global health</topic><topic>Health aspects</topic><topic>Highly active antiretroviral therapy</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Immunosuppression</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medicine</topic><topic>Meningitis</topic><topic>Meningitis, Cryptococcal - immunology</topic><topic>Meningitis, Cryptococcal - physiopathology</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Preempting</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Uganda</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Butler, Elissa K</creatorcontrib><creatorcontrib>Boulware, David R</creatorcontrib><creatorcontrib>Bohjanen, Paul R</creatorcontrib><creatorcontrib>Meya, David B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>TestCollectionTL3OpenAccess</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Butler, Elissa K</au><au>Boulware, David R</au><au>Bohjanen, Paul R</au><au>Meya, David B</au><au>Cameron, D. William</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long term 5-year survival of persons with cryptococcal meningitis or asymptomatic subclinical antigenemia in Uganda</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2012-12-10</date><risdate>2012</risdate><volume>7</volume><issue>12</issue><spage>e51291</spage><epage>e51291</epage><pages>e51291-e51291</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Data presented previously as an abstract at the 2011 CUGH Global Health Conference in Montreal, Canada on 15 Nov 2011. The long-term survival of HIV-infected persons with symptomatic cryptococcal meningitis and asymptomatic, subclinical cryptococcal antigenemia (CRAG+) is unknown. We prospectively enrolled 25 asymptomatic, antiretroviral therapy (ART)-naïve CRAG+ Ugandans with CD4<100 cells/mcL who received pre-emptive fluconazole treatment (CRAG+ cohort) and 189 ART-naïve Ugandans with symptomatic cryptococcal meningitis treated with amphotericin (CM cohort). The 10-week survival was 84% (95%CI: 70-98%) in the CRAG+ cohort and 57% (95%CI: 50%-64%) in the CM cohort. The CRAG+ cohort had improved five-year survival of 76% (95%CI: 59%-93%) compared to 42% (95%CI: 35%-50%) in the CM cohort (P = 0.001). The two cohorts had similar immunosuppression pre-ART with median CD4 counts of 15 vs. 21 CD4/mcL in the CRAG+ and CM cohorts, respectively (P = 0.45). Despite substantial early mortality, subsequent 5-year survival of persons surviving 6-months was excellent (>88%), demonstrating that long term survival is possible in resource-limited settings. Pre-ART CRAG screening with preemptive fluconazole treatment and improved CM treatment(s) are needed to reduce AIDS-attributable mortality due to cryptococcosis which remains 20-25% in sub-Saharan Africa.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23251485</pmid><doi>10.1371/journal.pone.0051291</doi><tpages>e51291</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2012-12, Vol.7 (12), p.e51291-e51291 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1970861421 |
| source | MEDLINE; TestCollectionTL3OpenAccess; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Acquired immune deficiency syndrome Adult AIDS Antigenemia Antigens Antigens, Fungal - blood Antiretroviral agents Antiretroviral drugs Antiretroviral therapy CD4 antigen Clinical trials Cohort Studies Cryptococcal meningitis Cryptococcosis Drug dosages Drug therapy Female Fluconazole Fungal infections Global health Health aspects Highly active antiretroviral therapy HIV Human immunodeficiency virus Humans Immunosuppression Infections Infectious diseases Male Medicine Meningitis Meningitis, Cryptococcal - immunology Meningitis, Cryptococcal - physiopathology Middle Aged Mortality Preempting Survival Survival Analysis Uganda |
| title | Long term 5-year survival of persons with cryptococcal meningitis or asymptomatic subclinical antigenemia in Uganda |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T11%3A56%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Long%20term%205-year%20survival%20of%20persons%20with%20cryptococcal%20meningitis%20or%20asymptomatic%20subclinical%20antigenemia%20in%20Uganda&rft.jtitle=PloS%20one&rft.au=Butler,%20Elissa%20K&rft.date=2012-12-10&rft.volume=7&rft.issue=12&rft.spage=e51291&rft.epage=e51291&rft.pages=e51291-e51291&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0051291&rft_dat=%3Cgale_plos_%3EA477084081%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1970861421&rft_id=info:pmid/23251485&rft_galeid=A477084081&rft_doaj_id=oai_doaj_org_article_c2595b37571c40588ce57523b6966426&rfr_iscdi=true |