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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2013
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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. |
format | Online Article Text |
id | pubmed-3747670 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
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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