Survival time of HIV-infected patients with cryptococcal meningitis
Objective: To study survival time and risk factors of mortality among HIV-infected patients who had cryptococcal meningitis. Design: Retrospective cohort study. Material and Method: Patients' medical records of those who had HIV-infection with newly diagnosed cryptoccocal meningitis between Jan...
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th-mahidol.247242018-08-24T09:00:13Z Survival time of HIV-infected patients with cryptococcal meningitis Suthat Chottanapund Pratap Singhasivanon Jaranit Kaewkungwal Kanittha Chamroonswasdi Weerawat Manosuthi Mahidol University Thailand Ministry of Public Health Medicine Objective: To study survival time and risk factors of mortality among HIV-infected patients who had cryptococcal meningitis. Design: Retrospective cohort study. Material and Method: Patients' medical records of those who had HIV-infection with newly diagnosed cryptoccocal meningitis between January 2002 and December 2004 were reviewed. Each patient was classified into one of two groups, according to their anti-retroviral status (ART). Results: Five hundred and forty nine patients enrolled in the present study: 281 (51.2%) in the ART+ group and 268 (48.8%) in the ART-group. The mean age was 33.4 ± 6.9 years old in the ART + group and 33.6 ± 7.0 years old in the ART-group. There were more male in both groups: 207 males and 74 females in the ART+ group, and 195 males and 73 females in the ART-group. Baseline CD4 cell count of both groups was 20 (6-74) cells/ mL and 24 (9-72) cells/ ml. About 30% of both groups of patients experienced major opportunistic infection before cryptococcal meningitis. All patients were treated by standard amphotericin B for a 2-week duration followed by fluconazole for an additional 8 weeks. There were no differences of baseline characteristics between the two groups (p > 0.05). The survival rates at 12, 24, and 36 months were 92.8%, 87.4%, and 85.4% in the ART+ group and 55.3%, 42.2%, and 36.8% in the ART- group, respectively (p < 0.01). The median survival time in the ART- group was 15 months. From the Cox regression model, the hazard ratio for "not received ART" was 4.87 (95%CI = 2.48-9.44, p < 0.01). Conclusion: The present study demonstrated the substantial increasing of survival time of HIV-infected patients with cryptococcal meningitis by initiated ART, even in a resource limited setting (no flucytosine, local combined antiretroviral drugs with NVP based regimens). 2018-08-24T02:00:13Z 2018-08-24T02:00:13Z 2007-10-01 Review Journal of the Medical Association of Thailand. Vol.90, No.10 (2007), 2104-2111 01252208 01252208 2-s2.0-35848947740 https://repository.li.mahidol.ac.th/handle/123456789/24724 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=35848947740&origin=inward |
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Medicine Suthat Chottanapund Pratap Singhasivanon Jaranit Kaewkungwal Kanittha Chamroonswasdi Weerawat Manosuthi Survival time of HIV-infected patients with cryptococcal meningitis |
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Objective: To study survival time and risk factors of mortality among HIV-infected patients who had cryptococcal meningitis. Design: Retrospective cohort study. Material and Method: Patients' medical records of those who had HIV-infection with newly diagnosed cryptoccocal meningitis between January 2002 and December 2004 were reviewed. Each patient was classified into one of two groups, according to their anti-retroviral status (ART). Results: Five hundred and forty nine patients enrolled in the present study: 281 (51.2%) in the ART+ group and 268 (48.8%) in the ART-group. The mean age was 33.4 ± 6.9 years old in the ART + group and 33.6 ± 7.0 years old in the ART-group. There were more male in both groups: 207 males and 74 females in the ART+ group, and 195 males and 73 females in the ART-group. Baseline CD4 cell count of both groups was 20 (6-74) cells/ mL and 24 (9-72) cells/ ml. About 30% of both groups of patients experienced major opportunistic infection before cryptococcal meningitis. All patients were treated by standard amphotericin B for a 2-week duration followed by fluconazole for an additional 8 weeks. There were no differences of baseline characteristics between the two groups (p > 0.05). The survival rates at 12, 24, and 36 months were 92.8%, 87.4%, and 85.4% in the ART+ group and 55.3%, 42.2%, and 36.8% in the ART- group, respectively (p < 0.01). The median survival time in the ART- group was 15 months. From the Cox regression model, the hazard ratio for "not received ART" was 4.87 (95%CI = 2.48-9.44, p < 0.01). Conclusion: The present study demonstrated the substantial increasing of survival time of HIV-infected patients with cryptococcal meningitis by initiated ART, even in a resource limited setting (no flucytosine, local combined antiretroviral drugs with NVP based regimens). |
author2 |
Mahidol University |
author_facet |
Mahidol University Suthat Chottanapund Pratap Singhasivanon Jaranit Kaewkungwal Kanittha Chamroonswasdi Weerawat Manosuthi |
format |
Review |
author |
Suthat Chottanapund Pratap Singhasivanon Jaranit Kaewkungwal Kanittha Chamroonswasdi Weerawat Manosuthi |
author_sort |
Suthat Chottanapund |
title |
Survival time of HIV-infected patients with cryptococcal meningitis |
title_short |
Survival time of HIV-infected patients with cryptococcal meningitis |
title_full |
Survival time of HIV-infected patients with cryptococcal meningitis |
title_fullStr |
Survival time of HIV-infected patients with cryptococcal meningitis |
title_full_unstemmed |
Survival time of HIV-infected patients with cryptococcal meningitis |
title_sort |
survival time of hiv-infected patients with cryptococcal meningitis |
publishDate |
2018 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/24724 |
_version_ |
1763497174193143808 |