Long term mortality and disability in Cryptococcal Meningitis: a systematic literature review. - Pasquier, Estelle; Kunda, John; DeBeaudrap, Pierre; Loyse, Angela; Temfack, Elvis; Molloy, Síle F; Harrison, Thomas S; Lortholary, Olivier (Clinical Infectious Diseases, 2017)
Cryptococcal meningitis (CM) is the primary cause of meningitis in adults with human immunodeficiency virus (HIV) infection and an emerging disease in HIV-seronegative individuals. No literature review has studied the long-term outcome of CM. We performed a systematic review on the long-term (>= 3-month) impact of CM (Cryptococcus neoformans and Cryptococcus gattii) on mortality and disability in HIV-infected and non-HIV-infected adults. Although the quality of current evidence is limited, the long-term impact of CM on survival and disability seems to be high. One-year mortality ranged from 13% in an Australian non-HIV-infected C. gattii-infected cohort to 78% in a Malawian HIV-infected cohort treated with fluconazole monotherapy. One-year impairment proportions among survivors ranged from 19% in an Australian C. gattii cohort to >70% in a Taiwanese non-HIV- and HIV-infected cohorts. Ongoing early therapeutic interventions, early detection of impairments and access to rehabilitation services may significantly improve patients' survival and quality of life.
Keywords: journalArticle; cryptococcal meningitis; disability; factors; long-term outcome; mortality; risk