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Cited by 13Fungal Infections and StudiesParasitic infections in humans and animalsParasitic Infections and Diagnostics

Changing demographics and risk factors for cryptococcosis: A 12-year review at a tertiary care centre.

Bhatt, Mahesh, Porterfield, J. Zachary, Ribes, Julie A., Arora, Vaneet, Myint, Thein·2021·Mycoses
DOI 10.1111/myc.13323
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Abstract

Background: Cryptococcosis is classically associated with the immunocompromised patients but there is a rising appreciation for its impact on the immunocompetent hosts. We sought to analyse the trends, diagnosis, treatment of different hosts and the effect of immunodeficiency and chronic liver disease on relapse and in‐house mortality. Methods: This is a retrospective study of 12 years of patients with cryptococcosis, divided into three different groups: HIV‐infected, transplant and non‐HIV non‐transplant (NHNT). Data were analysed with Chi‐square, unpaired parametric t test, simple and multivariate logistic regression analysis. Results: Of 114 identified patients, 23 (20.2%) had HIV infection, 11 (9.6%) had transplant, 80 (70.2%) were NHNT patients. Overall, mortality was 28.1% (32/114) and relapse occurred in 10.5% (12/114) of patients. The mortality trend was higher (OR = 2.346, p = .287) in the transplant group (45.5%, 5/11) than in HIV (26.1%, 6/23) and NHNT groups (26.3%, 21/80). HIV was associated with relapse; 30.4% (7/23) for HIV‐positive patients and 5.5% (5/91) for HIV‐negative patients (OR = 7.525, p = .002). Chronic liver disease had a large and statistically significant association with mortality on multivariate analysis (OR = 3.583, p = .013) which was more pronounced than the HIV or transplant groups. It was independently associated with mortality by chi‐square analysis (OR 3.137, p = .012). Conclusion: Chronic liver disease represented 30.7% (35/114) of all studied patients. It was a risk factor for in‐hospital mortality. HIV infection and transplant were not statistically significant for mortality. Relapse was highest in the HIV‐infected patients at 30.4% (7/23). These data highlight the effect of type and degree of immunocompromise on cryptococcosis.

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  • In a single-center retrospective study of individuals with cryptococcosis, cryptococcosis in Hispanic persons and black or African American persons was more common in the HIV-infected group compared to the transplant and non-HIV/non-transplant groups (p < 0.0001).

    “Cryptococcosis in Hispanic persons and black or African American persons was more common in the HIV-infected group compared to the transplant and non-HIV/non-transplant (NHNT) groups (p < 0.0001).”

    From Race and ethnicity: Risk factors for fungal infections? (2023) · cites this paper as [129]

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Authors
Bhatt, M., Porterfield, J. Z., Ribes, J. A., Arora, V., & Myint, T.
Affiliations
  • North Mississippi Medical Center (US)
  • University of Kentucky (US)
Corresponding author
Myint, Thein
ORCID
Venue
Mycoses
Publisher
Wiley
Published
2021-06-10
Volume
64
Issue
9
Pages
1073-1082
ISSN
  • 0027-5557 (ISSN-L)
  • 0933-7407
  • 1439-0507
DOI
10.1111/myc.13323
OpenAlex
W3164807279
Cited by
13
References
33
Citations by year
2026: 2 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 1
FWCI
1.62
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Mycoses (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Parasitic infections in humans and animals
  • Life Sciences › Immunology and Microbiology › Parasitology › Parasitic Infections and Diagnostics
Keywords
cryptococcosis, cryptococcal meningitis, immunocompromised patients, HIV infection, organ transplantation, chronic liver disease, in-hospital mortality, relapse, risk factors, immunosuppression
MeSH terms
Cryptococcosis, Humans, Recurrence, Retrospective Studies, Risk Factors, HIV Infections, End Stage Liver Disease, Tertiary Care Centers

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