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Macrophage Cholesterol Depletion and Its Effect on the Phagocytosis of Cryptococcus neoformans
11:07

Macrophage Cholesterol Depletion and Its Effect on the Phagocytosis of Cryptococcus neoformans

Published on: December 19, 2014

Central nervous system involvement in cryptococcal infection in individuals after solid organ transplantation or with

J A Davis1, D L Horn, K A Marr

  • 1Transplant Infectious Disease Program, Infectious Disease Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.

Transplant Infectious Disease : an Official Journal of the Transplantation Society
|July 30, 2009
PubMed
Abstract

Insights

Cryptococcal infections, particularly meningitis, are more common in HIV-positive patients than solid organ transplant recipients. Survival rates for cryptococcosis in immunocompromised individuals have improved.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Mycology

Background:

  • Cryptococcus neoformans is a significant pathogen in immunocompromised individuals.
  • Previous studies have not extensively compared cryptococcal infection manifestations across different immune deficiency types.

Purpose of the Study:

  • To compare the clinical manifestations and outcomes of Cryptococcus neoformans infections in distinct immunocompromised populations.
  • To investigate the impact of different immune deficits on cryptococcal disease presentation and severity.

Main Methods:

  • Analysis of clinical data from the Prospective Antifungal Therapy (PATH) Alliance registry.
  • Inclusion of 235 cases of proven Cryptococcus neoformans infection between March 2004 and April 2008.
  • Comparison of infection patterns between solid organ transplant (SOT) recipients, human immunodeficiency virus (HIV)-infected patients, and individuals with other risk factors.

Main Results:

  • Central nervous system (CNS) involvement was significantly more frequent in HIV-infected patients (84.1%) compared to SOT recipients (44.2%).
  • Solid organ transplant recipients on calcineurin inhibitors (CNIs) showed a reduced likelihood of CNS cryptococcosis.
  • Overall 12-week mortality was 22.6%, with variations across patient groups (SOT: 21.2%, HIV: 15.9%, Other: 32.9%).

Conclusions:

  • HIV infection is associated with a higher incidence of CNS cryptococcosis compared to SOT recipients.
  • The protective role of CNIs against CNS cryptococcosis warrants further investigation.
  • Improved survival in cryptococcal infections among immunocompromised hosts suggests therapeutic advancements.

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