Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America

Jose E. Vidal, Augusto C. Penalva de Oliveira, Rafi F. Dauar, David R. Boulware

Research output: Contribution to journalShort surveypeer-review

37 Scopus citations

Abstract

Latin America is the region with the third most AIDS-related cryptococcal meningitis infections globally. Highly active antiretroviral therapy (HAART) has reduced the number of infections; however, the number of deaths and the case-fatality rate continues to be unacceptable. In this review, we focus on the burden of AIDS-related cryptococcosis in Latin America and discuss potential strategies to reduce early mortality from Cryptococcus. In this review, we highlight the importance of: (1) earlier HIV diagnosis and HAART initiation with retention-in-care to avoid AIDS; (2) pre-HAART cryptococcal antigen (CRAG) screening with preemptive fluconazole treatment; (3) better diagnostics (e.g. CRAG testing); and (4) optimal treatment with aggressive management of intracranial pressure and induction therapy with antifungal combination. Implementation of these strategies can reduce cryptococcal-related deaths, improve care, and reduce healthcare costs.

Original languageEnglish (US)
Pages (from-to)353-362
Number of pages10
JournalBrazilian Journal of Infectious Diseases
Volume17
Issue number3
DOIs
StatePublished - May 1 2013

Keywords

  • Cryptococcal meningitis
  • Cryptococccosis
  • Diagnosis
  • Epidemiology
  • Latin America
  • Mortality
  • Treatment

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