| DB ID | MyCo_4932 |
| Title | Clinical features and serum biomarkers in HIV immune reconstitution inflammatory syndrome after cryptococcal meningitis: a prospective cohort study |
| Year | 2010 |
| PMID | 21253011 |
| Fungal Diseases involved | Cryptococcal meningitis |
| Associated Medical Condition | HIV-AIDS immune reconstitution inflammatory syndrome (IRIS) |
| Genus | Cryptococcus |
| Species | spp. |
| Organism | Cryptococcus spp. |
| Ethical Statement | Each participant provided written informed consent for protocols approved by the institutional review boards at the University of Minnesota, Makerere University, and Uganda National Council for Science and Technology. |
| Site of Infection | None |
| Opportunistic invasive | None |
| Sample type | Body fluid |
| Sample source | Serum |
| Host Group | Human |
| Host Common name | Human |
| Host Scientific name | Homo sapiens |
| Biomarker Name | TNF-α |
| Biomarker Full Name | Tumor Necrosis Factor alpha |
| Biomarker Type | Diagnostic |
| Biomolecule | Protein |
| Geographical Location | USA |
| Cohort | One hundred two ART-naı ¨ve patients with AIDS and recent CM were enrolled for 12 mo of longitudinal evaluation after ART initiation. |
| Cohort No. | 102 |
| Age Group | None |
| P Value | p=0.27 |
| Sensitivity | None |
| Specificity | None |
| Positive Predictive Value | None |
| MIC | None |
| Fold Change | None |
| Pathway | None |
| Disease Introduction Mechanism | Cryptococcal meningitis (CM), caused by the fungal organism Cryptococcus neoformans (commonly termed simply ‘‘cryptococcus’’) is the most common fatal central nervous system (CNS) infection in persons with AIDS and is the initial AIDS-defining illness in 20%– 30% of AIDS patients in Africa, causing 20%–40% of AIDS- attributable mortality. The US Centers for Disease Control (CDC) estimates approximately 1 million CM cases occur annually, with 70% in sub-Saharan Africa. The incidence of CM among Ugandans with CD4 counts ,200 cells/ml is 10% annually without antiretroviral therapy (ART), and without ART, almost all persons with CM die within 6 mo. Although ART availability has led to improved CM survival in Africa, mortality after CM is still high, in part due to paradoxical HIV immune reconstitution inflammatory syndrome (IRIS), an exag- gerated inflammatory response causing a subset of persons with recent CM to paradoxically deteriorate on ART in the presence of improving immune function. Paradoxical CM-IRIS incidence has been reported as 10%–42% among ART-naı ¨ ve persons with CM, with a pooled average of 18% (95% CI 14%– 23%). CM-IRIS is of grave concern because of its high incidence and mortality (33%–66%). In many resource-limited regions, particularly sub-Saharan Africa where CM is the second most common AIDS-defining opportunistic infection, CM-IRIS is a major clinical problem. |
| Technique | Assay |
| Analysis Method | Luminex multiplex assays |
| ELISA kits | None |
| Assay Data | None |
| Validation Techniques used | Luminex multiplex assays |
| Up Regulation Down Regulation | Increase |
| Sequence Data | None |
| External Link | None |
