title: Human immunodeficiency virus type 1 subtype and other factors associated with extrapulmonary Cryptococcosis among patients in Thailand with AIDS.
abstract: Delineating factors associated with extrapulmonary cryptococcosis (EPC), a major disease burden among Thailand's AIDS patients, can clarify its pathogenesis and guide preventive interventions. From November 1993 through June 1996, enhanced surveillance of 2261 human immunodeficiency virus (HIV)-seropositive patients in a hospital near Bangkok showed EPC among 561 of 1553 AIDS patients (36.1%). Univariate analysis results were confirmed by multivariate analyses of data on 1259 patients. Logistic regression models identified factors significantly associated with EPC to be male sex (adjusted odds ratio [aOR], 2.0; 95% confidence interval [CI], 1.3-2.9), age <33 years (aOR, 1.5; 95% CI, 1.2-1.9), severe immunosuppression (aOR, 1.8; 95% CI, 1.3-2.6), not injecting drugs (aOR, 3.0; 95% CI, 1.7-5.5), and infection with HIV-1 circulating from CRF01_AE (formerly subtype E) versus subtype B (aOR, 2.3; 95% CI, 1.2-4.5). The association with CRF01_AE may result from undetermined markers of exposure or viral subtype effects on host immune responses. Better understanding of the epidemiology of EPC may reduce EPC incidence through targeted primary prevention and treatment.
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: Pauli N
authors.initials: PN
authors.lastname: Amornkul
authors.forename: Dale J
authors.initials: DJ
authors.lastname: Hu
authors.forename: Somsit
authors.initials: S
authors.lastname: Tansuphasawadikul
authors.forename: Sherline
authors.initials: S
authors.lastname: Lee
authors.forename: Boonchuey
authors.initials: B
authors.lastname: Eampokalap
authors.forename: Sirirat
authors.initials: S
authors.lastname: Likanonsakul
authors.forename: Robert
authors.initials: R
authors.lastname: Nelson
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Young
authors.forename: Rana A
authors.initials: RA
authors.lastname: Hajjeh
authors.forename: Khanchit
authors.initials: K
authors.lastname: Limpakarnjanarat
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Mastro
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000382:microbiology; D000328:Adult; D003453:Cryptococcosis / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D015497:HIV-1 / Q000145:classification*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology