Differences in immunologic factors among patients presenting with altered mental status during cryptococcal meningitis

Sarah Lofgren; Kathy H. Hullsiek; Bozena M. Morawski; Henry W. Nabeta; Reuben Kiggundu; Kabanda Taseera; Abdu Musubire; Charlotte Schutz; Mahsa Abassi; Nathan C. Bahr; Lillian Tugume; Conrad Muzoora; Darlisha A. Williams; Melissa A. Rolfes; Sruti S. Velamakanni; Radha Rajasingham; Graeme Meintjes; Joshua Rhein; David B. Meya; David R. Boulware

doi:10.1093/infdis/jix033

Differences in immunologic factors among patients presenting with altered mental status during cryptococcal meningitis

Sarah Lofgren, Kathy H. Hullsiek, Bozena M. Morawski, Henry W. Nabeta, Reuben Kiggundu, Kabanda Taseera, Abdu Musubire, Charlotte Schutz, Mahsa Abassi, Nathan C. Bahr, Lillian Tugume, Conrad Muzoora, Darlisha A. Williams, Melissa A. Rolfes, Sruti S. Velamakanni, Radha Rajasingham, Graeme Meintjes, Joshua Rhein, David B. Meya, David R. Boulware

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Altered mental status in cryptococcal meningitis results in poorer survival, but underlying causes of altered mentation are poorly understood. Within two clinical trials, we assessed risk factors for altered mental status (GCS score<15) considering baseline clinical characteristics, CSF cytokines/chemokines, and antiretroviral therapy. Among 326 enrolled participants, 97 (30%) had GCS<15 and these patients had lower median CSF cryptococcal antigen titers (P = .042) and CCL2 (P = .005) but higher opening pressures (320 vs. 269 mm H2O; P = .016), IL-10 (P = .044), and CCL3 (P = .008) compared with persons with GCS=15. Altered mental status may be associated with host immune response rather than Cryptococcus burden.

Original language	English (US)
Pages (from-to)	693-697
Number of pages	5
Journal	Journal of Infectious Diseases
Volume	215
Issue number	5
DOIs	https://doi.org/10.1093/infdis/jix033
State	Published - Mar 1 2017

Bibliographical note

Publisher Copyright:
© The Author 2017.

Keywords

Altered mental status
Cryptococcal meningitis
Cytokines
HIV
Immunology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.1093/infdis/jix033

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388270

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Lofgren, S., Hullsiek, K. H., Morawski, B. M., Nabeta, H. W., Kiggundu, R., Taseera, K., Musubire, A., Schutz, C., Abassi, M., Bahr, N. C., Tugume, L., Muzoora, C., Williams, D. A., Rolfes, M. A., Velamakanni, S. S., Rajasingham, R., Meintjes, G., Rhein, J., Meya, D. B., & Boulware, D. R. (2017). Differences in immunologic factors among patients presenting with altered mental status during cryptococcal meningitis. Journal of Infectious Diseases, 215(5), 693-697. https://doi.org/10.1093/infdis/jix033

Lofgren, S, Hullsiek, KH, Morawski, BM, Nabeta, HW, Kiggundu, R, Taseera, K, Musubire, A, Schutz, C, Abassi, M, Bahr, NC, Tugume, L, Muzoora, C, Williams, DA, Rolfes, MA, Velamakanni, SS, Rajasingham, R, Meintjes, G, Rhein, J, Meya, DB & Boulware, DR 2017, 'Differences in immunologic factors among patients presenting with altered mental status during cryptococcal meningitis', Journal of Infectious Diseases, vol. 215, no. 5, pp. 693-697. https://doi.org/10.1093/infdis/jix033

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abstract = "Altered mental status in cryptococcal meningitis results in poorer survival, but underlying causes of altered mentation are poorly understood. Within two clinical trials, we assessed risk factors for altered mental status (GCS score<15) considering baseline clinical characteristics, CSF cytokines/chemokines, and antiretroviral therapy. Among 326 enrolled participants, 97 (30%) had GCS<15 and these patients had lower median CSF cryptococcal antigen titers (P = .042) and CCL2 (P = .005) but higher opening pressures (320 vs. 269 mm H2O; P = .016), IL-10 (P = .044), and CCL3 (P = .008) compared with persons with GCS=15. Altered mental status may be associated with host immune response rather than Cryptococcus burden.",

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author = "Sarah Lofgren and Hullsiek, {Kathy H.} and Morawski, {Bozena M.} and Nabeta, {Henry W.} and Reuben Kiggundu and Kabanda Taseera and Abdu Musubire and Charlotte Schutz and Mahsa Abassi and Bahr, {Nathan C.} and Lillian Tugume and Conrad Muzoora and Williams, {Darlisha A.} and Rolfes, {Melissa A.} and Velamakanni, {Sruti S.} and Radha Rajasingham and Graeme Meintjes and Joshua Rhein and Meya, {David B.} and Boulware, {David R.}",

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AU - Schutz, Charlotte

AU - Abassi, Mahsa

AU - Bahr, Nathan C.

AU - Tugume, Lillian

AU - Muzoora, Conrad

AU - Williams, Darlisha A.

AU - Rolfes, Melissa A.

AU - Velamakanni, Sruti S.

AU - Rajasingham, Radha

AU - Meintjes, Graeme

AU - Rhein, Joshua

AU - Meya, David B.

AU - Boulware, David R.

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KW - Immunology

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Differences in immunologic factors among patients presenting with altered mental status during cryptococcal meningitis

Abstract

Bibliographical note

Keywords

UN SDGs

Publisher link

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