Cryptococcal Disease in the Era of "Test and Treat": Is There Cause for Concern?

Mahsa Abassi; Joshua Rhein; David B Meya; David R Boulware

doi:10.1093/ofid/ofx274

Cryptococcal Disease in the Era of "Test and Treat": Is There Cause for Concern?

Open Forum Infect Dis. 2017 Dec 26;5(1):ofx274. doi: 10.1093/ofid/ofx274. eCollection 2018 Jan.

Authors

Mahsa Abassi^{1

2}, Joshua Rhein^{1

2}, David B Meya^{1

2

3}, David R Boulware²

Affiliations

¹ Infectious Diseases Institute, Kampala, Uganda.
² University of Minnesota, Minneapolis, Minnesota.
³ School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.

Abstract

Treatment of cryptococcosis requires deferred initiation of antiretroviral therapy (ART). Early ART initiation may be detrimental in the context of cryptococcal infection by increasing the risk of immune reconstitution inflammatory syndrome (IRIS). We present 3 cases where early ART initiation in the presence of unrecognized cryptococcal disease had fatal outcomes.

Keywords: HIV; cryptococcal immune reconstitution syndrome; test and treat.

Abstract

Grants and funding