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Published on: February 27, 2018
Cryptococcus Neoformans Meningitis Cases Among China's HIV-Infected Population may have been Severely Under-Reported
Min Chen1, Nan Xu2, Jianping Xu3
1Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Abstract:
Cryptococcal meningitis (CM) is the leading fungal infection of the central nervous system. Globally, most CM cases have been reported from patients with compromised immunities, especially those infected with HIV. However, reports from China have shown that most CM infections were from HIV-negative, immunocompetent hosts. Here, we reviewed the published reports and found those studies were almost exclusively based on patients from hospitals associated with Chinese universities but not from specialized infectious diseases hospitals where most Chinese HIV-infected patients have been treated. Thus, we believe CM cases among China's HIV-infected population may have been severely under-reported. Analyses of CM cases in specialized infectious diseases hospitals are needed to identify the true epidemiological pattern of CM in China.
Insights
Cryptococcal meningitis (CM) is a major fungal central nervous system infection. Studies in China may under-report cases in HIV-infected individuals by excluding specialized infectious disease hospitals.
Area of Science:
- Infectious Diseases
- Mycology
- Epidemiology
Background:
- Cryptococcal meningitis (CM) is a leading fungal infection of the central nervous system.
- Globally, CM predominantly affects immunocompromised individuals, particularly those with HIV.
- Recent Chinese reports suggest CM primarily occurs in HIV-negative, immunocompetent hosts.
Purpose of the Study:
- To investigate the potential under-reporting of cryptococcal meningitis (CM) in HIV-infected populations in China.
- To identify the true epidemiological pattern of CM in China.
Main Methods:
- A review of published reports on CM cases in China.
- Analysis of study populations, focusing on hospital types (university-affiliated vs. specialized infectious disease hospitals).
Main Results:
- Published CM studies in China predominantly sourced data from university-affiliated hospitals.
- These hospitals may not represent the primary treatment centers for HIV-infected patients in China.
- This sampling bias likely leads to an under-representation of CM cases in the HIV-infected population.
Conclusions:
- Cryptococcal meningitis cases among HIV-infected individuals in China may be severely under-reported.
- Further analysis of CM cases in specialized infectious disease hospitals is crucial for accurate epidemiological assessment in China.
