Is HIV-associated tuberculosis a risk factor for the development of cryptococcal disease?
Cryptococcal meningitis and tuberculosis are leading causes of mortality in patients initiating antiretroviral therapy in Africa. We hypothesized that a history of tuberculosis may predispose to the development of cryptococcal meningitis and examined the association using multivariate logistic regression in a cohort of patients initiating antiretroviral therapy. History of pulmonary tuberculosis was independently associated with the development of cryptococcal meningitis (odds ratio = 6.6; 95% confidence interval = 1.3-32.7) after adjustment for covariates, including CD4 cell counts. A number of potential mechanisms may underlie this association.
Jarvis
Joseph N
JN
Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Harrison
Thomas S
TS
Corbett
Elizabeth L
EL
Wood
Robin
R
Lawn
Stephen D
SD
D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000821:virology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000209:etiology* / Q000821:virology; D012044:Regression Analysis; D012307:Risk Factors; D013019:South Africa; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000821:virology