Evidence map›Paper›PMID 38854002›Full record

ArticlemedRxiv : the preprint server for health sciences2024

Impact of Cerebrospinal Fluid Leukocyte Infiltration and Neuroimmmune Mediators on Survival with HIV-Associated Cryptococcal Meningitis.

Samuel Okurut, David R Boulware, Yukari C Manabe, Lillian Tugume, Caleb P Skipper, Kenneth Ssebambulidde, Joshua Rhein, Abdu K Musubire, Andrew Akampurira, Elizabeth Okafor and 4 more

Abstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Samuel OkurutResearch Department, Infectious Diseases Institute, Makerere University, Kampala, Uganda.ORCID 0000-0002-9292-8687
David R BoulwareDivision of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.ORCID 0000-0002-4715-0060
Yukari C ManabeResearch Department, Infectious Diseases Institute, Makerere University, Kampala, Uganda.ORCID 0000-0001-8619-5598
Lillian TugumeResearch Department, Infectious Diseases Institute, Makerere University, Kampala, Uganda.ORCID 0000-0002-1293-1545
Caleb P SkipperDivision of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.ORCID 0000-0002-0000-8876
Kenneth SsebambuliddeResearch Department, Infectious Diseases Institute, Makerere University, Kampala, Uganda.ORCID 0000-0002-8125-0698
Joshua RheinDivision of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.ORCID 0000-0002-0480-9646
Abdu K MusubireResearch Department, Infectious Diseases Institute, Makerere University, Kampala, Uganda.ORCID 0000-0003-2410-5344
Andrew AkampuriraResearch Department, Infectious Diseases Institute, Makerere University, Kampala, Uganda.
Elizabeth OkaforDivision of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Joseph O OloboDepartment of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.ORCID 0000-0001-5148-8876
Edward N JanoffMucosal and Vaccine Research Program Colorado, Department of Medicine, Division of Infectious Diseases, University of Colorado Denver, Aurora, Colorado, CO. USA.ORCID 0000-0003-2702-5729
David B MeyaResearch Department, Infectious Diseases Institute, Makerere University, Kampala, Uganda.ORCID 0000-0002-8854-0321
ASTRO Trial Team.

Funding

NPGH LEADERs YR12: OBSSR (Greenberg, Ngwafong Mukere) & NIBIB (Lee)D43TW009345 · FIC · UNIVERSITY OF WASHINGTON · PI Dibyadyuti Datta, Chandy C. John · 2017 to 2026
$15.2M
Improving Diagnostics and Neurocognitive Outcomes in HIV/AIDS-related MeningitisR01NS086312 · NINDS · UNIVERSITY OF MINNESOTA · PI David R Boulware, David Bisagaya Meya · 2013 to 2026
$8.3M
Infectious Disease Training in Clinical InvestigationT32AI055433 · NIAID · UNIVERSITY OF MINNESOTA TWIN CITIES · PI David R Boulware · 2003 to 2026
$6.1M
Northern/Pacific Universities Global Health Research Training ConsortiumR25TW009345 · FIC · UNIVERSITY OF WASHINGTON · PI KOLARS, JOSEPH C., NERURKAR, VIVEK RAMCHANDRA · 2012 to 2016
$5.9M
TB Meningitis: Evaluating CSF Immunology to Discover Hidden Disease and Potential Immunomodulatory TherapiesR01AI162786 · NIAID · UNIVERSITY OF MINNESOTA · PI BOULWARE, DAVID R, MEYA, DAVID BISAGAYA · 2021 to 2025
$3.3M
HIV Co-infections in Uganda: TB, Cryptococcus, and Viral Hepatitis.D43TW009771 · FIC · JOHNS HOPKINS UNIVERSITY · PI CASTELNUOVO, BARBARA, KAMBUGU, ANDREW DDUNGU · 2014 to 2023
$3.3M
Mechanisms of Impaired HIV-associated B cell and Pneumococcal Vaccine responsesR01AI108479 · NIAID · UNIVERSITY OF COLORADO DENVER · PI JANOFF, EDWARD N · 2014 to 2018
$2.3M
Outcomes of Cryptococcal Meningitis in UgandaK24AI096925 · NIAID · UNIVERSITY OF MINNESOTA · PI BOHJANEN, PAUL R · 2011 to 2015
$1.0M
The immunopathogenesis of HIV-related Immune Reconstitution Inflammatory SyndromeR01AI078934 · NIAID · INFECTIOUS DISEASES INSTITUTE · PI KAMBUGU, ANDREW DDUNGU, MEYA, DAVID BISAGAYA · 2010 to 2013
$415k
Impact of HIV and HIV therapy on the Etiology and Outcome of Meningitis in UgandaR21NS065713 · NINDS · UNIVERSITY OF MINNESOTA · PI BOHJANEN, PAUL R, BOULWARE, DAVID R · 2010 to 2011
$276k
Impact of HIV-1 and Aging on Mucosal Vaccine ResponsesI01CX001464 · VA · VA EASTERN COLORADO HEALTH CARE SYSTEM · PI JANOFF, EDWARD N · 2017 to 2021
–
CSRD VA I01 CX001464FIC NIH HHS D43 TW009345FIC NIH HHS D43 TW009771FIC NIH HHS R25 TW009345NIAID NIH HHS K24 AI096925NIAID NIH HHS R01 AI078934NIAID NIH HHS R01 AI108479NIAID NIH HHS R01 AI162786NIAID NIH HHS T32 AI055433NINDS NIH HHS R01 NS086312NINDS NIH HHS R21 NS065713Wellcome Trust
6 · The paper itself

Abstract

Introduction: Cryptococcal meningitis remains a prominent cause of death in persons with advanced HIV disease. CSF leukocyte infiltration predicts survival at 18 weeks; however, how CSF immune response relates to CSF leukocyte infiltration is unknown. Methods: We enrolled 401 adults with HIV-associated cryptococcal meningitis in Uganda who received amphotericin and fluconazole induction therapy. We assessed the association of CSF leukocytes, chemokine, and cytokine responses with 18-week survival. Results: Participants with CSF leukocytes ≥50/μL, had higher probability 68% (52/77) of 18-week survival compared with 52% (151/292) 18-week survival in those with ≤50 cells/μL (Hazard Ratio=1.63, 95% confidence intervals 1.14-2.23; p=0.008). Survival was also associated with higher expression of T helper (Th)-1, Th17 cytokines, and immune regulatory elements. CSF levels of Programmed Death-1 Ligand, CXCL10, and Interleukin (IL)-2 independently predicted survival. In multivariate analysis, CSF leukocytes were inversely associated with CSF fungal burden and positively associated with CSF protein, interferon-gamma (IFN-γ), IL-17A, tumor necrosis factor (TNF)-α, and peripheral blood CD4 Conclusion: 18-week survival after diagnosis of cryptococcal meningitis was associated with higher CSF leukocytes at baseline with greater T helper 1 (IFN-γ, IL-2 and TNF-α cytokines), T helper 17 (IL-17A cytokine) and CXCR3

Indexed as

antifungal therapycerebrospinal fluidchemokinesCSF white cellscytokinesfungal burdenHIV-associated cryptococcal meningitisimmune responsesurvival

Identifiers

PMID38854002
PMCPMC11160828

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.