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Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America

Latin America is the region with the third most AIDS-related cryptococcal meningitis infections globally. Highly active antiretroviral therapy (HAART) has reduced the number of infections; however, the number of deaths and the case-fatality rate continues to be unacceptable. In this review, we focus...

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Autores principales: Vidal, Jose E., Penalva de Oliveira, Augusto C., Dauar, Rafi F., Boulware, David R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747670/
https://www.ncbi.nlm.nih.gov/pubmed/23665012
http://dx.doi.org/10.1016/j.bjid.2012.10.020
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author Vidal, Jose E.
Penalva de Oliveira, Augusto C.
Dauar, Rafi F.
Boulware, David R.
author_facet Vidal, Jose E.
Penalva de Oliveira, Augusto C.
Dauar, Rafi F.
Boulware, David R.
author_sort Vidal, Jose E.
collection PubMed
description Latin America is the region with the third most AIDS-related cryptococcal meningitis infections globally. Highly active antiretroviral therapy (HAART) has reduced the number of infections; however, the number of deaths and the case-fatality rate continues to be unacceptable. In this review, we focus on the burden of AIDS-related cryptococcosis in Latin America and discuss potential strategies to reduce early mortality from Cryptococcus. In this review, we highlight the importance of: (1) earlier HIV diagnosis and HAART initiation with retention-in-care to avoid AIDS; (2) pre-HAART cryptococcal antigen (CRAG) screening with preemptive fluconazole treatment; (3) better diagnostics (e.g. CRAG testing); and (4) optimal treatment with aggressive management of intracranial pressure and induction therapy with antifungal combination. Implementation of these strategies can reduce cryptococcal-related deaths, improve care, and reduce healthcare costs.
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spelling pubmed-37476702014-05-10 Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America Vidal, Jose E. Penalva de Oliveira, Augusto C. Dauar, Rafi F. Boulware, David R. Braz J Infect Dis Review Article Latin America is the region with the third most AIDS-related cryptococcal meningitis infections globally. Highly active antiretroviral therapy (HAART) has reduced the number of infections; however, the number of deaths and the case-fatality rate continues to be unacceptable. In this review, we focus on the burden of AIDS-related cryptococcosis in Latin America and discuss potential strategies to reduce early mortality from Cryptococcus. In this review, we highlight the importance of: (1) earlier HIV diagnosis and HAART initiation with retention-in-care to avoid AIDS; (2) pre-HAART cryptococcal antigen (CRAG) screening with preemptive fluconazole treatment; (3) better diagnostics (e.g. CRAG testing); and (4) optimal treatment with aggressive management of intracranial pressure and induction therapy with antifungal combination. Implementation of these strategies can reduce cryptococcal-related deaths, improve care, and reduce healthcare costs. Elsevier 2013-05-10 /pmc/articles/PMC3747670/ /pubmed/23665012 http://dx.doi.org/10.1016/j.bjid.2012.10.020 Text en © 2013 Elsevier Editora Ltda. Este é um artigo Open Access sob a licença de CC BY-NC-ND. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review Article
Vidal, Jose E.
Penalva de Oliveira, Augusto C.
Dauar, Rafi F.
Boulware, David R.
Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America
title Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America
title_full Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America
title_fullStr Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America
title_full_unstemmed Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America
title_short Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America
title_sort strategies to reduce mortality and morbidity due to aids-related cryptococcal meningitis in latin america
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747670/
https://www.ncbi.nlm.nih.gov/pubmed/23665012
http://dx.doi.org/10.1016/j.bjid.2012.10.020
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