ArticleOpen forum infectious diseases2018
Detrimental Outcomes of Unmasking Cryptococcal Meningitis With Recent ART Initiation.
Article in Open forum infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
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
48 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM.The Lancet. Infectious diseases · 2024Guideline
- Efficacy of induction regimens for cryptococcal meningitis in HIV-infected adults: a systematic review and network meta-analysis.Scientific reports · 2021Pooled it
- Adjunctive sertraline for HIV-associated cryptococcal meningitis: a randomised, placebo-controlled, double-blind phase 3 trial.The Lancet. Infectious diseases · 2019Trial
- Temporal shifts in adaptive immunity drive HIV-associated cryptococcal IRIS: mechanisms, models, and therapeutic opportunities.NeuroImmune pharmacology and therapeutics · 2026Article
- Review of Risk Factors and Factors Influencing Outcomes of Cryptococcal Meningitis in Persons Living with HIV.Infection and drug resistance · 2026Review
- Revisiting Immune-Mediated Mechanisms as Drivers of Cryptococcal Immune Reconstitution Inflammatory Syndrome.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Therapeutic Repurposing of Sertraline: Evidence for Its Antifungal Activity from In Vitro, In Vivo, and Clinical Studies.Microorganisms · 2025Review
- Article
- Recent Antiretroviral Therapy Initiation Is Associated With Increased Mortality Risk in HIV-associated Cryptococcal Meningitis: An Analysis of Clinical Trial Data From Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Cerebrospinal Fluid Cytokines and Chemokines Involved in Cytotoxic Cell Function and Risk of Acute 14-Day Mortality in Persons with Advanced HIV and Cryptococcal Meningitis.The Journal of infectious diseases · 2025Article
- The evolution of HIV-associated cryptococcal meningitis in Uganda from 2010 to 2022.Medical mycology · 2024Article
- Article
- Management and outcome of intracranial fungal infections in children and adults in Africa: a scoping review.BMC infectious diseases · 2024Article
- Molecular Diagnostics ofDiseases (Basel, Switzerland) · 2024Review
- Diagnosis and management of cryptococcal meningitis in HIV-infected adults.Clinical microbiology reviews · 2023Review
- Cryptococcal meningitis.Nature reviews. Disease primers · 2023Review
- Shared and unique antibody and B cell profiles in HIV-positive and HIV-negative individuals with cryptococcal meningoencephalitis.Medical mycology · 2023Article
- Disseminated Cryptococcosis Is a Common Finding among Human Immunodeficiency Virus-Infected Patients with Suspected Sepsis and Is Associated with Higher Mortality Rates.Journal of fungi (Basel, Switzerland) · 2023Article
- Advanced HIV disease: A review of diagnostic and prophylactic strategies.HIV medicine · 2023Review
- Prevalence and Factors Associated With Cryptoccocal Antigenemia Among Patients With Advanced Human Immunodeficiency Virus in Eastern Uganda: A Facility-Based Cross-sectional Study.Open forum infectious diseases · 2023Article
Corrections and comments
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Authors and funding
17 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundIncreased antiretroviral therapy (ART) availability has been associated with more patients developing cryptococcosis after ART initiation. Despite this changing epidemiology, data regarding cryptococcal meningitis in those already receiving ART are limited. We compared clinical presentations and outcomes among ART-naïve and ART-experienced Ugandans.
methodsWe prospectively enrolled 605 HIV-infected persons with first-episode cryptococcal meningitis from August 2013 to May 2017 who received amphotericin-based combination therapy. We classified participants by ART status and ART duration and compared groups for 2-week survival.
resultsOverall, 46% (281/605) of participants were receiving ART at presentation. Compared with those not receiving ART, those receiving ART had higher CD4 counts (
conclusionsCryptococcosis after ART initiation is common in Africa. Patients initiating ART who unmask cryptococcal meningitis are at a high risk of death. Immune recovery in the setting of central nervous system infection is detrimental, and management of this population requires further study. Implementing pre-ART cryptococcal antigen screening is urgently needed to prevent cryptococcal meningitis after ART initiation.
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Registered trials
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