title: Epidemiology of Cryptococcus and cryptococcosis in China.
abstract: Cryptococcosis is a significant invasive fungal infection with noteworthy morbidity and mortality, primarily caused by Cryptococcus neoformans and Cryptococcus gattii. In China, C. neoformans var. grubii (especially molecular type VNI) is the most common variety in the environment and responsible for the majority of cryptococcal infections. C. gattii infections are quite rare in China and the primary molecular type is VGI, which is closely related to C. gattii isolates in Australia. Interestingly, the majority of cryptococcosis in China were reported in the HIV-uninfected patients (especially immunocompetent hosts). This unique phenomenon may be attributed to multiple polymorphisms in the genes encoding mannose-binding lectin (MBL) and Fc-gamma receptor 2B (FCGR2B) in the Han population, the major ethnic group in China. Compared to immunocompromised patients, immunocompetent patients with cryptococcal meningitis often presented with more intense inflammatory responses and more severe neurological complications, but less fungal burdens and disseminated infection. The overall prognosis, which is independently associated with amphotericin B-based initial therapy, is similar between immunocompetent and immunocompromised patients. In addition, intrathecal administration of amphotericin B has been proved to be an effective adjunctive treatment for cryptococcosis in China.
authors.affiliation: Department of Dermatology and Venereology, Changzheng Hospital, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Fang
authors.affiliation: Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Shanghai, China.
authors.forename: Zhenzong
authors.initials: Z
authors.lastname: Fa
authors.affiliation: Department of Dermatology and Venereology, Changzheng Hospital, Shanghai, China; Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Shanghai, China. Electronic address: liaowanqing@sohu.com.
authors.forename: Wanqing
authors.initials: W
authors.lastname: Liao
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D003453:Cryptococcosis / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D003455:Cryptococcus neoformans / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D005838:Genotype; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007278:Injections, Spinal; D017720:Molecular Epidemiology; D016533:Mycological Typing Techniques; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B
keywords: Cryptococcosis; Ecology; Epidemiology; Mortality; Treatment