PMID- 34033158
OWN - NLM
STAT- MEDLINE
DCOM- 20220106
LR  - 20220106
IS  - 1439-0507 (Electronic)
IS  - 0933-7407 (Linking)
VI  - 64
IP  - 9
DP  - 2021 Sep
TI  - Changing demographics and risk factors for cryptococcosis: A 12-year review at a 
      tertiary care centre.
PG  - 1073-1082
LID - 10.1111/myc.13323 [doi]
AB  - BACKGROUND: Cryptococcosis is classically associated with the immunocompromised 
      patients but there is a rising appreciation for its impact on the immunocompetent 
      hosts. We sought to analyse the trends, diagnosis, treatment of different hosts 
      and the effect of immunodeficiency and chronic liver disease on relapse and 
      in-house mortality. METHODS: This is a retrospective study of 12 years of 
      patients with cryptococcosis, divided into three different groups: HIV-infected, 
      transplant and non-HIV non-transplant (NHNT). Data were analysed with Chi-square, 
      unpaired parametric t test, simple and multivariate logistic regression analysis. 
      RESULTS: Of 114 identified patients, 23 (20.2%) had HIV infection, 11 (9.6%) had 
      transplant, 80 (70.2%) were NHNT patients. Overall, mortality was 28.1% (32/114) 
      and relapse occurred in 10.5% (12/114) of patients. The mortality trend was 
      higher (OR = 2.346, p = .287) in the transplant group (45.5%, 5/11) than in HIV 
      (26.1%, 6/23) and NHNT groups (26.3%, 21/80). HIV was associated with relapse; 
      30.4% (7/23) for HIV-positive patients and 5.5% (5/91) for HIV-negative patients 
      (OR = 7.525, p = .002). Chronic liver disease had a large and statistically 
      significant association with mortality on multivariate analysis (OR = 3.583, 
      p = .013) which was more pronounced than the HIV or transplant groups. It was 
      independently associated with mortality by chi-square analysis (OR 3.137, 
      p = .012). CONCLUSION: Chronic liver disease represented 30.7% (35/114) of all 
      studied patients. It was a risk factor for in-hospital mortality. HIV infection 
      and transplant were not statistically significant for mortality. Relapse was 
      highest in the HIV-infected patients at 30.4% (7/23). These data highlight the 
      effect of type and degree of immunocompromise on cryptococcosis.
CI  - (c) 2021 Wiley-VCH GmbH.
FAU - Bhatt, Mahesh
AU  - Bhatt M
AD  - Division of Infectious Diseases, Department of Internal Medicine, North 
      Mississippi Medical Center, Tupelo, MS, USA.
FAU - Porterfield, J Zachary
AU  - Porterfield JZ
AD  - Division of Infectious Diseases, Department of Internal Medicine, University of 
      Kentucky, Lexington, KY, USA.
AD  - Department of Microbiology, Immunology, and Molecular Genetics, University of 
      Kentucky, Lexington, KY, USA.
FAU - Ribes, Julie A
AU  - Ribes JA
AD  - Department of Pathology and Laboratory Medicine, University of Kentucky College 
      of Medicine, Lexington, KY, USA.
FAU - Arora, Vaneet
AU  - Arora V
AD  - Department of Pathology and Laboratory Medicine, University of Kentucky College 
      of Medicine, Lexington, KY, USA.
FAU - Myint, Thein
AU  - Myint T
AUID- ORCID: 0000-0002-6164-4120
AD  - Division of Infectious Diseases, Department of Internal Medicine, University of 
      Kentucky, Lexington, KY, USA.
LA  - eng
PT  - Journal Article
DEP - 20210610
PL  - Germany
TA  - Mycoses
JT  - Mycoses
JID - 8805008
SB  - IM
MH  - *Cryptococcosis/epidemiology/mortality
MH  - *End Stage Liver Disease/epidemiology
MH  - *HIV Infections/epidemiology
MH  - Humans
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Tertiary Care Centers
OTO - NOTNLM
OT  - HIV
OT  - chronic liver disease
OT  - cryptococcus
OT  - immunocompromise
OT  - transplant
EDAT- 2021/05/26 06:00
MHDA- 2022/01/07 06:00
CRDT- 2021/05/25 14:11
PHST- 2021/05/11 00:00 [revised]
PHST- 2021/04/03 00:00 [received]
PHST- 2021/05/18 00:00 [accepted]
PHST- 2021/05/26 06:00 [pubmed]
PHST- 2022/01/07 06:00 [medline]
PHST- 2021/05/25 14:11 [entrez]
AID - 10.1111/myc.13323 [doi]
PST - ppublish
SO  - Mycoses. 2021 Sep;64(9):1073-1082. doi: 10.1111/myc.13323. Epub 2021 Jun 10.