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Cryptococcosis: the 1981-2000 epidemic.

Gary D Friedman1, W Jeffrey Fessel, Natalia V Udaltsova

  • 1Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94612, USA. gdf@dor.kaiser.org

Mycoses
|March 4, 2005
PubMed
Summary
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Cryptococcosis incidence rose in men during the early AIDS epidemic, then declined in HIV-positive individuals before widespread treatment. This fungal infection was rare in non-predisposed populations.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Cryptococcosis is a serious fungal infection, particularly in immunocompromised individuals.
  • Previous decade data established a baseline for cryptococcosis incidence.
  • Understanding trends is crucial for public health interventions.

Purpose of the Study:

  • To determine the 20-year incidence of cryptococcosis (1981-2000) in a large health care program.
  • To analyze incidence trends in the general population and specifically in HIV-positive individuals.
  • To assess changes in cryptococcosis rates relative to the AIDS epidemic.

Main Methods:

  • Retrospective analysis of medical records from a Northern California health care program.
  • Calculation of incidence rates per million person-years for males and females.

Related Experiment Videos

  • Stratification of data for HIV-positive patients to identify specific trends.

    • Main Results:

    • Overall 20-year incidence was 19.0/million person-years in males and 2.6 in females.
    • Male incidence peaked between 1981-1992, then declined; female incidence peaked later in 1997.
    • In HIV-positive patients, incidence was highest in 1981-1985 (men) and 1986-1990 (women), decreasing thereafter.

    Conclusions:

    • Cryptococcosis incidence significantly increased in men during the early AIDS epidemic.
    • Incidence began decreasing in HIV-positive patients before the advent of highly active antiretroviral therapy (HAART).
    • The study highlights the impact of the AIDS epidemic on fungal infections and suggests factors influencing trends beyond treatment availability.