ArticleBMC neurology2017
Neurocognitive function in HIV-infected persons with asymptomatic cryptococcal antigenemia: a comparison of three prospective cohorts.
Article in BMC neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Trial of High-Dose Oral Rifampin in Adults with Tuberculous Meningitis.The New England journal of medicine · 2025Trial
- Trial
- Adjunctive sertraline for HIV-associated cryptococcal meningitis: a randomised, placebo-controlled, double-blind phase 3 trial.The Lancet. Infectious diseases · 2019Trial
- Cerebral Perfusion Pressures and Implications on Clinical Outcomes and Medical Management in Cryptococcal Meningitis.Open forum infectious diseases · 2025Article
- Neurocognitive Impairment Among Cryptococcal Meningitis Survivors in Uganda, a Prospective Cohort Study.Open forum infectious diseases · 2025Article
- Neurocognitive outcomes of tuberculous meningitis in a primarily HIV-positive Ugandan cohort.Wellcome open research · 2021Article
- Seizures in Human Immunodeficiency Virus-Associated Cryptococcal Meningitis: Predictors and Outcomes.Open forum infectious diseases · 2019Article
- Mortality After Cryptococcal Infection in the Modern Antiretroviral Therapy Era.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Global HIV neurology: a comprehensive review.AIDS (London, England) · 2019Review
- Human Immunodeficiency Virus in the Brain-Culprit or Facilitator?Infectious diseases · 2018Review
- Neurological Sequelae of Adult Meningitis in Africa: A Systematic Literature Review.Open forum infectious diseases · 2018Review
- HIV-Associated Cryptococcal Disease in Resource-Limited Settings: A Case for "Prevention Is Better Than Cure"?Journal of fungi (Basel, Switzerland) · 2017Review
Corrections and comments
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Authors and funding
20 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundHIV-infected persons with detectable cryptococcal antigen (CrAg) in blood have increased morbidity and mortality compared with HIV-infected persons who are CrAg-negative. This study examined neurocognitive function among persons with asymptomatic cryptococcal antigenemia.
methodsParticipants from three prospective HIV cohorts underwent neurocognitive testing at the time of antiretroviral therapy (ART) initiation. Cohorts included persons with cryptococcal meningitis (N = 90), asymptomatic CrAg + (N = 87), and HIV-infected persons without central nervous system infection (N = 125). Z-scores for each neurocognitive test were calculated relative to an HIV-negative Ugandan population with a composite quantitative neurocognitive performance Z-score (QNPZ-8) created from eight tested domains. Neurocognitive function was measured pre-ART for all three cohorts and additionally after 4 weeks of ART (and 6 weeks of pre-emptive fluconazole) treatment among asymptomatic CrAg + participants.
resultsCryptococcal meningitis and asymptomatic CrAg + participants had lower median CD4 counts (17 and 26 cells/μL, respectively) than the HIV-infected control cohort (233 cells/μL) as well as lower Karnofsky performance status (60 and 70 vs. 90, respectively). The composite QNPZ-8 for asymptomatic CrAg + (-1.80 Z-score) fell between the cryptococcal meningitis cohort (-2.22 Z-score, P = 0.02) and HIV-infected controls (-1.36, P = 0.003). After four weeks of ART and six weeks of fluconazole, the asymptomatic CrAg + cohort neurocognitive performance improved (-1.0 Z-score, P < 0.001).
conclusionSignificant deficits in neurocognitive function were identified in asymptomatic CrAg + persons with advanced HIV/AIDS even without signs or sequelae of meningitis. Neurocognitive function in this group improves over time after initiation of pre-emptive fluconazole treatment and ART, but short term adherence support may be necessary.
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