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真菌负荷和颅内压升高与人类免疫缺陷病毒相关隐球菌性脑膜炎患者的视力丧失独立相关。

Fungal Burden and Raised Intracranial Pressure Are Independently Associated With Visual Loss in Human Immunodeficiency Virus-Associated Cryptococcal Meningitis.

作者信息

Molloy Síle F, Ross Brad, Kanyama Cecilia, Mfinanga Sayoki, Lesikari Sokoine, Heyderman Robert S, Kalata Newton, Ellis Jayne, Kouanfack Charles, Chanda Duncan, Temfack Elvis, Lakhi Shabir, Moodley Anand, Chan Adrienne K, van Oosterhout Joep J, Mapoure Yacouba, Mwaba Peter, Lalloo David G, Wang Duolao, Lortholary Olivier, Jaffar Shabbar, Hosseinipour Mina C, Loyse Angela, Harrison Thomas S, Bicanic Tihana

机构信息

Centre for Global Health, Institute of Infection and Immunity, St George's University of London, London, United Kingdom.

Clinical Academic Group in Infection, St George's University Hospital, LondonUnited Kingdom.

出版信息

Open Forum Infect Dis. 2021 Feb 5;8(4):ofab066. doi: 10.1093/ofid/ofab066. eCollection 2021 Apr.

DOI:10.1093/ofid/ofab066
PMID:33937434
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8078267/
Abstract

Among 472 patients with human immunodeficiency virus-associated cryptococcal meningitis, 16% had severe visual loss at presentation, and 46% of these were 4-week survivors and remained severely impaired. Baseline cerebrospinal fluid opening pressure ≥40 cmHO (adjusted odds ratio [aOR], 2.56; 95% confidence interval [CI], 1.36-4.83; = .02) and fungal burden >6.0 log colonies/mL (aOR, 3.01; 95% CI, 1.58-5.7; = .003) were independently associated with severe visual loss.

摘要

在472例人类免疫缺陷病毒相关隐球菌性脑膜炎患者中,16%在就诊时出现严重视力丧失,其中46%为4周幸存者且仍有严重视力损害。基线脑脊液开放压≥40 cmH₂O(校正比值比[aOR],2.56;95%置信区间[CI],1.36 - 4.83;P = .02)和真菌负荷>6.0 log菌落/mL(aOR,3.01;95% CI,1.58 - 5.7;P = .003)与严重视力丧失独立相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97d4/8078267/0eefa6254638/ofab066_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97d4/8078267/0eefa6254638/ofab066_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97d4/8078267/0eefa6254638/ofab066_fig1.jpg

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N Engl J Med. 2018 Mar 15;378(11):1004-1017. doi: 10.1056/NEJMoa1710922.
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Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis.
用于预测中国 HIV 感染者中与隐球菌性脑膜炎相关的矛盾性免疫重建炎症综合征的列线图。
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