Literature DB >> 28329080

Differences in Immunologic Factors Among Patients Presenting with Altered Mental Status During Cryptococcal Meningitis.

Sarah Lofgren1,2, Kathy H Hullsiek1, Bozena M Morawski1, Henry W Nabeta2, Reuben Kiggundu2, Kabanda Taseera3, Abdu Musubire2, Charlotte Schutz4, Mahsa Abassi1,2, Nathan C Bahr1,5, Lillian Tugume2, Conrad Muzoora3, Darlisha A Williams1,2, Melissa A Rolfes1, Sruti S Velamakanni1, Radha Rajasingham1, Graeme Meintjes4, Joshua Rhein1,2, David B Meya1,2, David R Boulware1.   

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.
© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Entities:  

Keywords:  Cryptococcal meningitis; HIV; altered mental status; cytokines.; immunology

Mesh：

Substances：

Year:  2017        PMID： 28329080      PMCID： PMC5388270          DOI： 10.1093/infdis/jix033

Source DB:  PubMed          Journal:  J Infect Dis        ISSN： 0022-1899            Impact factor:   5.226


  13 in total

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Review 3.  Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS.

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4.  Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis.

Authors:  David R Boulware; David B Meya; Conrad Muzoora; Melissa A Rolfes; Katherine Huppler Hullsiek; Abdu Musubire; Kabanda Taseera; Henry W Nabeta; Charlotte Schutz; Darlisha A Williams; Radha Rajasingham; Joshua Rhein; Friedrich Thienemann; Melanie W Lo; Kirsten Nielsen; Tracy L Bergemann; Andrew Kambugu; Yukari C Manabe; Edward N Janoff; Paul R Bohjanen; Graeme Meintjes
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6.  Early or late IL-10 blockade enhances Th1 and Th17 effector responses and promotes fungal clearance in mice with cryptococcal lung infection.

Authors:  Benjamin J Murdock; Seagal Teitz-Tennenbaum; Gwo-Hsiao Chen; Anthony J Dils; Antoni N Malachowski; Jeffrey L Curtis; Michal A Olszewski; John J Osterholzer
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7.  Early ART After Cryptococcal Meningitis Is Associated With Cerebrospinal Fluid Pleocytosis and Macrophage Activation in a Multisite Randomized Trial.

Authors:  James E Scriven; Joshua Rhein; Katherine Huppler Hullsiek; Maximilian von Hohenberg; Grace Linder; Melissa A Rolfes; Darlisha A Williams; Kabanda Taseera; David B Meya; Graeme Meintjes; David R Boulware
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8.  Determinants of mortality in a combined cohort of 501 patients with HIV-associated Cryptococcal meningitis: implications for improving outcomes.

Authors:  Joseph N Jarvis; Tihana Bicanic; Angela Loyse; Daniel Namarika; Arthur Jackson; Jesse C Nussbaum; Nicky Longley; Conrad Muzoora; Jacob Phulusa; Kabanda Taseera; Creto Kanyembe; Douglas Wilson; Mina C Hosseinipour; Annemarie E Brouwer; Direk Limmathurotsakul; Nicholas White; Charles van der Horst; Robin Wood; Graeme Meintjes; John Bradley; Shabbar Jaffar; Thomas Harrison
Journal:  Clin Infect Dis       Date:  2013-12-06       Impact factor: 9.079

9.  The phenotype of the Cryptococcus-specific CD4+ memory T-cell response is associated with disease severity and outcome in HIV-associated cryptococcal meningitis.

Authors:  Joseph N Jarvis; Joseph P Casazza; Hunter H Stone; Graeme Meintjes; Stephen D Lawn; Stuart M Levitz; Thomas S Harrison; Richard A Koup
Journal:  J Infect Dis       Date:  2013-03-14       Impact factor: 5.226

10.  Efficacy of adjunctive sertraline for the treatment of HIV-associated cryptococcal meningitis: an open-label dose-ranging study.

Authors:  Joshua Rhein; Bozena M Morawski; Kathy Huppler Hullsiek; Henry W Nabeta; Reuben Kiggundu; Lillian Tugume; Abdu Musubire; Andrew Akampurira; Kyle D Smith; Ali Alhadab; Darlisha A Williams; Mahsa Abassi; Nathan C Bahr; Sruti S Velamakanni; James Fisher; Kirsten Nielsen; David B Meya; David R Boulware
Journal:  Lancet Infect Dis       Date:  2016-03-10       Impact factor: 25.071
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1.  Cerebrospinal Fluid Early Fungicidal Activity as a Surrogate Endpoint for Cryptococcal Meningitis Survival in Clinical Trials.

Authors:  Matthew F Pullen; Katherine Huppler Hullsiek; Joshua Rhein; Abdu K Musubire; Lillian Tugume; Edwin Nuwagira; Mahsa Abassi; Kenneth Ssebambulidde; Edward Mpoza; Ruben Kiggundu; Andrew Akampurira; Henry W Nabeta; Charlotte Schutz; Emily E Evans; Radha Rajasingham; Caleb P Skipper; Katelyn A Pastick; Darlisha A Williams; Bozena M Morawski; Ananta S Bangdiwala; Graeme Meintjes; Conrad Muzoora; David B Meya; David R Boulware
Journal:  Clin Infect Dis       Date:  2020-10-23       Impact factor: 9.079

2.  HIV-Associated Cryptococcal Meningitis Occurring at Relatively Higher CD4 Counts.

Authors:  Lillian Tugume; Joshua Rhein; Kathy Huppler Hullsiek; Edward Mpoza; Reuben Kiggundu; Kenneth Ssebambulidde; Charlotte Schutz; Kabanda Taseera; Darlisha A Williams; Mahsa Abassi; Conrad Muzoora; Abdu K Musubire; Graeme Meintjes; David B Meya; David R Boulware
Journal:  J Infect Dis       Date:  2019-02-23       Impact factor: 5.226

3.  Unveil the transcriptional landscape at the Cryptococcus-host axis in mice and nonhuman primates.

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Journal:  PLoS Negl Trop Dis       Date:  2019-07-22

4.  The clinical characteristics and outcome of cryptococcal meningitis with AIDS in a tertiary hospital in China: an observational cohort study.

Authors:  Liang Wu; Jiang Xiao; Yangzi Song; Guiju Gao; Hongxin Zhao
Journal:  BMC Infect Dis       Date:  2020-12-01       Impact factor: 3.090

5.  Association of Hyponatremia on Mortality in Cryptococcal Meningitis: A Prospective Cohort.

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Journal:  Open Forum Infect Dis       Date:  2022-06-17       Impact factor: 4.423

6.  Neurocognitive outcomes of tuberculous meningitis in a primarily HIV-positive Ugandan cohort.

Authors:  Carson M Quinn; John Kasibante; Alice Namudde; Ananta S Bangdiwala; Mable Kabahubya; Noeline Nakasujja; Sarah Lofgren; Alison Elliott; David R Boulware; David B Meya; Fiona V Cresswell
Journal:  Wellcome Open Res       Date:  2022-03-03

7.  Seizures in Human Immunodeficiency Virus-Associated Cryptococcal Meningitis: Predictors and Outcomes.

Authors:  Katelyn A Pastick; Ananta S Bangdiwala; Mahsa Abassi; Andrew G Flynn; Bozena M Morawski; Abdu K Musubire; Prosperity C Eneh; Charlotte Schutz; Kabanda Taseera; Joshua Rhein; Kathy Huppler Hullsiek; Melanie R Nicol; Jose E Vidal; Noeline Nakasujja; Graeme Meintjes; Conrad Muzoora; David B Meya; David R Boulware
Journal:  Open Forum Infect Dis       Date:  2019-11-05       Impact factor: 3.835
  7 in total

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