Journal article

HIV combination therapy: partial immune restitution unmasking latent cryptococcal infection

ML Woods, R MacGinley, DP Eisen, AM Allworth

AIDS | LIPPINCOTT WILLIAMS & WILKINS | Published : 1998

Abstract

OBJECTIVE: To describe two cases of cryptococcal meningitis and one re-exacerbation of Cryptococcus-associated meningitis occurring in temporal association with commencement of highly active antiretroviral therapy (HAART) in patients with advanced HIV infection (CD4 cells 2-4 log10 reduction) HIV viral loads (two out of three patients), and (iii) prominent inflammatory changes in cerebrospinal fluid (white blood cells > 10 x 10(6)/l) at diagnosis (two out of three patients). CONCLUSIONS: Our report suggests that in patients with advanced HIV infection, partial immune restitution induced by HAART can precipitate onset of clinically apparent meningitis in those patients with latent cryptococc..

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