What to know
Cryptococcal meningitis is especially prevalent among people with HIV/AIDS. Antiretroviral therapy (ART) in the United States has greatly reduced the number of people with HIV/AIDS who get infected. In parts of the world without access to ART, cryptococcal meningitis is a leading cause of death among people with HIV/AIDS. The species Cryptococcus gatti, found throughout the world, can cause cryptococcosis in anyone but people with weakened immune systems are at higher risk.
Trends
Global trends
Cryptococcal meningitis is a significant risk for people living with HIV/AIDS. It is a major problem in countries with high HIV prevalence and limited access to healthcare. Each year, an estimated 152,000 cases of cryptococcal meningitis occur among people living with HIV worldwide. Among those cases, an estimated 112,000 deaths occur, the majority of which occur in sub-Saharan Africa. Cryptococcal meningitis is one of the leading causes of death among people living with HIV patients in sub-Saharan Africa.
Trends in the United States
Before the availability of antiretroviral therapy (ART) cryptococcal meningitis was a major concern for people living with advanced HIV. Early HIV diagnosis and uptake of ART significantly reduced cryptococcosis and related deaths among people with HIV in the U.S. However, people living with HIV/AIDS should still remain cautious to prevent infections.
Death rates
Studies from Australia, Papua New Guinea, British Columbia, Canada; and the US, report C. gattii death rates from 13% to 33%. Patient characteristics, treatment, and length of follow up likely contribute to differences in death rates in different areas.
Public health surveillance
Cryptococcus infections are reportable in certain US states. Laboratories are also encouraged to send C. gattii isolates to the Mycotic Diseases Branch Laboratory. Submissions should come through state public health labs and include appropriate clinical information.