Diagnosis, Prevention, and Management of Cryptococcus Infection (Meningeal and Non-Meningeal)

Investigator: George Rutherford, MD
Sponsor: World Health Organization (WHO)

Location(s): United States


Increasing access to antiretroviral therapy (ART) has transformed the prognosis of HIV-infected patients in resource-limited settings (RLS). However, treatment coverage remains relatively low, and HIV diagnosis occurs at a late stage. As a result, many patients continue to die of HIV-related opportunistic infections (OIs) in the weeks prior to, and months following initiation of ART. Cryptococcal disease is one of the most important OIs, and a major contributor to this early mortality, accounting for between 13% and 44% of deaths in HIV-infected cohorts in resource-limited countries. In subSaharan Africa alone, there are more than 500,000 deaths each year due to cryptococcal meningitis (CM).

During 2011, the WHO Department of HIV/AIDS in collaboration with the Department of Maternal, Child and Adolescent Health has worked to develop recommendations on diagnosis, prevention and management of cryptococcal disease in adults, adolescents and children. The evidence to support these recommendations has been assembled through a series of coordinated activities to review and synthesize existing and emerging evidence using systematic reviews, GRADE6 profile preparation and analysis, evaluation of recommendations in current national guidelines, survey of costs of diagnostics and drugs, and a country-level feasibility assessment. 

UCSF researchers participated in this development.