HIV-related cryptococcal meningitis in resource-limited settings

Abstract

Cryptococcal infection remains a significant problem in patients with AIDS in resource-limited settings. Even with the availability of HAART, the 6-month rate of survival after cryptococcal meningitis (CM) reported by several epidemiological studies is very low. The worldwide number of infections and deaths due to CM appears similar to those for diseases that have received greater public health attention. In sub-Saharan Africa, deaths due to CM may be more frequent than TB. However, in many developing countries the capacity to perform the complicated management of severe CM is limited and CM mortality may remain a problem in Africa, and also in areas where antiretroviral therapy is available, as late presentation with advanced disease is common and consequently IRIS is becoming an emerging problem. A focused effort to improve diagnostic capacity, expand treatment options, and identify effective measures for the prevention of cryptococcal disease is urgently required.