Pasquier E., Kunda J., Beaudrap Pierre de, Loyse A., Temfack E., Molloy S. F., Harrison T. S., Lortholary O. (2018). Long-term mortality and disability in cryptococcal meningitis : a systematic literature review. Clinical Infectious Diseases, 66 (7), 1122-1132. ISSN 1058-4838.
Titre du document
Long-term mortality and disability in cryptococcal meningitis : a systematic literature review
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.
