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Trends in Clinico-Epidemiological Profile and Outcomes of Patients with HIV-Associated Cryptococcal Meningitis in Shanghai, China, 2013-2023.

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اقرأ على الانترنت اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • المصدر:
      Publisher: MDPI Country of Publication: Switzerland NLM ID: 101509722 Publication Model: Electronic Cited Medium: Internet ISSN: 1999-4915 (Electronic) Linking ISSN: 19994915 NLM ISO Abbreviation: Viruses Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: Basel, Switzerland : MDPI
    • الموضوع:
      Meningitis, Cryptococcal*/epidemiology ; Meningitis, Cryptococcal*/mortality ; HIV Infections*/complications ; HIV Infections*/epidemiology ; AIDS-Related Opportunistic Infections*/epidemiology ; AIDS-Related Opportunistic Infections*/mortality; Humans ; China/epidemiology ; Female ; Male ; Adult ; Middle Aged ; Prognosis ; CD4 Lymphocyte Count ; Prevalence ; Incidence ; Young Adult
    • نبذة مختصرة :
      The study aimed to analyze changes in the clinical and epidemiological aspects of HIV-associated cryptococcal meningitis (CM) patients and to identify factors influencing their prognosis. Clinical data of patients with HIV-associated CM treated in Shanghai, China between 2013 and 2023 were collected. This study included 279 cases, 2.89% of AIDS patients, showing a yearly decrease in CM prevalence among AIDS patients ( p < 0.001). Overall mortality was 10.39% with rates declining from a 2013 peak of 15.38% to 0% in 2023 despite no significant temporal pattern ( p = 0.265). Diagnosis took an average of 18 ± 1 days post-symptoms, and admission CD4 counts averaged 29.2 ± 2.5 cells/μL, hinting at a non-significant decline. Frequent symptoms included fever (62.4%), headache (61.6%), fatigue (44.1%), and appetite loss (39.8%), with younger patients more likely to initially show signs of meningeal irritation. Logistic regression analysis underscored the prognostic importance of cerebrospinal fluid (CSF) white blood cell (WBC) count and procalcitonin levels. Over the decade spanning from 2013 to 2023, the incidence and mortality rates of CM among AIDS patients exhibited a downward trend. The average duration from the onset of CM to confirmation of diagnosis remained prolonged. CSF WBC count and procalcitonin levels were associated with unfavorable outcomes.
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    • Grant Information:
      ZD2021CY001 Shanghai Municipal Science and Technology Major Project; 21Y31900400 Science and Technology Commission of Shanghai Municipality; SHDC22021317 Shanghai Hospital Development Center; SHDC2020CR6025 Shanghai Hospital Development Center; 20MC1920100 Science and Technology Commission of Shanghai Municipality
    • Contributed Indexing:
      Keywords: HIV/AIDS; clinical characteristics; cryptococcal meningitis; epidemiology; prognosis
    • الموضوع:
      Date Created: 20240829 Date Completed: 20240829 Latest Revision: 20240903
    • الموضوع:
      20240903
    • الرقم المعرف:
      PMC11359124
    • الرقم المعرف:
      10.3390/v16081333
    • الرقم المعرف:
      39205307