Human immunodeficiency virus type 1 subtype and other factors associated with extrapulmonary Cryptococcosis among patients in Thailand with AIDS

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)...

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Published inAIDS research and human retroviruses Vol. 19; no. 2; p. 85
Main Authors Amornkul, Pauli N, Hu, Dale J, Tansuphasawadikul, Somsit, Lee, Sherline, Eampokalap, Boonchuey, Likanonsakul, Sirirat, Nelson, Robert, Young, Nancy L, Hajjeh, Rana A, Limpakarnjanarat, Khanchit, Mastro, Timothy D
Format Journal Article
LanguageEnglish
Published United States 01.02.2003
Subjects
Adult
AIDS-Related Opportunistic Infections - epidemiology
AIDS-Related Opportunistic Infections - microbiology
Cryptococcosis - epidemiology
Cryptococcosis - microbiology
Female
HIV Infections - complications
HIV Infections - virology
HIV-1 - classification
Humans
Logistic Models
Male
Middle Aged
Risk Factors
Thailand - epidemiology
Thailand
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Summary: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.
ISSN:0889-2229
1931-8405
DOI:10.1089/088922203762688586