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Cited by 300

The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index.

Outcomes of Cryptococcal Meningitis in Uganda Before and After the Availability of Highly Active Antiretroviral Therapy

Open access
Kambugu, Andrew, Meya, David B., Rhein, Joshua, O’Brien, Meagan, Janoff, Edward N., Ronald, Allan R., Kamya, Moses R., Mayanja‐Kizza, Harriet, Sande, Merle A., Bohjanen, Paul R., Boulware, David R.·2008·Clinical Infectious Diseases
DOI 10.1086/587667
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Abstract

BACKGROUND: Cryptococcal meningitis (CM) is the proximate cause of death in 20%-30% of persons with acquired immunodeficiency syndrome in Africa. METHODS: Two prospective, observational cohorts enrolled human immunodeficiency virus (HIV)-infected, antiretroviral-naive persons with CM in Kampala, Uganda. The first cohort was enrolled in 2001-2002 (n = 92), prior to the availability of highly active antiretroviral therapy (HAART), and the second was enrolled in 2006-2007 (n = 44), when HAART was available. RESULTS: Ugandans presented with prolonged CM symptoms (median duration, 14 days; interquartile range, 7-21 days). The 14-day survival rates were 49% in 2001-2002 and 80% in 2006 (P < .001). HAART was started 35 +/- 13 days after CM diagnosis and does not explain the improved 14-day survival rate in 2006. In 2006-2007, the survival rate continued to decrease after hospitalization, with only 55% surviving to initiate HAART as an outpatient. Probable cryptococcal-related immune reconstitution inflammatory syndrome occurred in 42% of patients, with 4 deaths. At 6 months after CM diagnosis, 18 persons (41%) were alive and receiving HAART in 2007. The median cerebral spinal fluid (CSF) opening pressure was 330 mm H(2)O; 81% of patients had elevated pressure (>200 mm H(2)O). Only 5 patients consented to therapeutic lumbar puncture. There was a trend for higher mortality for pressures >250 mm H(2)O (odds ratio [OR], 2.1; 95% confidence interval [CI], 0.9-5.2; P = .09). Initial CSF WBC counts of <5 cells/mL were associated with failure of CSF sterilization (OR, 17.3; 95% CI, 3.1-94.3; P < .001), and protein levels <35 mg/dL were associated with higher mortality (OR, 2.0; 95% CI, 1.2-3.3; P = .007). CONCLUSIONS: Significant CM-associated mortality persists, despite the administration of amphotericin B and HIV therapy, because of the high mortality rate before receipt of HAART and because of immune reconstitution inflammatory syndrome-related complications after HAART initiation. Approaches to increase acceptance of therapeutic lumbar punctures are needed.

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Metadata

Authors
Kambugu, A., Meya, D. B., Rhein, J., O’Brien, M., Janoff, E. N., Ronald, A. R., Kamya, M. R., Mayanja‐Kizza, H., Sande, M. A., Bohjanen, P. R., & Boulware, D. R.
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2008-06
Volume
46
Issue
11
Pages
1694-1701
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/587667
OpenAlex
W2154894130
Cited by
300
References
27
FWCI
15.77
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Outcomes of Cryptococcal Meningitis in Uganda Before and After the Availability of Highly Active Antiretroviral Therapy. https://app.cochat.ai/papers/10.1086/587667
The paper
Kambugu, A., Meya, D. B., Rhein, J., O’Brien, M., Janoff, E. N., Ronald, A. R., Kamya, M. R., Mayanja‐Kizza, H., Sande, M. A., Bohjanen, P. R., & Boulware, D. R. (2008). Outcomes of Cryptococcal Meningitis in Uganda Before and After the Availability of Highly Active Antiretroviral Therapy. Clinical Infectious Diseases. https://doi.org/10.1086/587667

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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