Kassaza Kennedy, Wasswa Fredrickson, Nielsen Kirsten, Bazira Joel
Department of Microbiology and Parasitology, Mbarara University of Science and Technology, Mbarara P.O. Box 1410, Uganda.
Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN 55455, USA.
J Fungi (Basel). 2022 Jul 15;8(7):734. doi: 10.3390/jof8070734.
Cryptococcal meningoencephalitis, a disease with poor patient outcomes, remains the most prevalent invasive fungal infection worldwide, accounting for approximately 180,000 deaths each year. In several areas of sub-Saharan Africa with the highest HIV prevalence, cryptococcal meningitis is the leading cause of community-acquired meningitis, with a high mortality among HIV-infected individuals. Recent studies show that patient disease outcomes are impacted by the genetics of the infecting isolate. Yet, there is still limited knowledge of how these genotypic variations contribute to clinical disease outcome. Further, it is unclear how the genetic heterogeneity of and the extensive phenotypic variation observed between and within isolates affects infection and disease. In this review, we discuss current knowledge of how various genotypes impact disease progression and patient outcome in HIV-positive populations in sub-Saharan African, a setting with a high burden of cryptococcosis.
隐球菌性脑膜脑炎患者预后较差，仍是全球最常见的侵袭性真菌感染，每年导致约18万人死亡。在撒哈拉以南非洲艾滋病毒感染率最高的几个地区，隐球菌性脑膜炎是社区获得性脑膜炎的主要病因，在艾滋病毒感染者中死亡率很高。最近的研究表明，患者的疾病预后受感染菌株遗传学的影响。然而，对于这些基因型变异如何导致临床疾病预后，人们仍然知之甚少。此外，尚不清楚分离株之间以及分离株内部观察到的遗传异质性和广泛的表型变异如何影响感染和疾病。在本综述中，我们讨论了在隐球菌病负担沉重的撒哈拉以南非洲地区，不同基因型如何影响艾滋病毒阳性人群疾病进展和患者预后的现有知识。
