ArticleMycopathologia2025
Impact of Cryptococcosis on the Immune Recovery of Patients with AIDS and Severe Immunosuppression.
Article in Mycopathologia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionCryptococcosis is a systemic mycosis prevalent in immunosuppressed individuals, particularly those with HIV/AIDS. Immune recovery achieved through antiretroviral therapy (ART) is crucial for controlling opportunistic infections in AIDS. Given clinical observations and evidence suggesting Cryptococcus spp. accelerates HIV replication in vitro, we hypothesized that cryptococcosis may hinder immune recovery in severely immunosuppressed AIDS patients.
objectiveTo investigate the association between cryptococcosis and immune recovery in AIDS patients with severe immunosuppression (CD4 + T-cells ≤ 200 cells/mm
methodsFrom 230 consecutive patients, those followed for > 100 days were included in a matched cohort study: 21 with cryptococcosis and 67 without, matched by CD4 + T-cells range at a 3:1 ratio. Immune recovery was defined as achieving a CD4 + T-cells count ≥ 350 cells/mm
resultsImmune recovery rates were lower in the cryptococcosis group (19.0 vs. 38.8%, p = 0.096). Multivariate analysis revealed that younger age (< 40 years), undetectable HIV viral load, and longer follow-up were independently associated with immune recovery. Patients with cryptococcosis had a 3.61-fold increased odds of immune recovery failure (95% CI 0.90-14.53; p = 0.071), approaching statistical significance.
conclusionThese findings suggest that cryptococcosis may impair immune recovery in AIDS patients with severe immunosuppression. Further studies with larger cohorts are needed to confirm these results.
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