Fungal Burden and Raised Intracranial Pressure Are Independently Associated With Visual Loss in Human Immunodeficiency Virus-Associated Cryptococcal Meningitis
Síle F. Molloy, B.A. Ross, Cecilia Kanyama, Sayoki Mfinanga, Sokoine Lesikari, Robert S. Heyderman, Newton Kalata, Jayne Ellis, Charles Kouanfack, Duncan Chanda, Elvis Temfack, Shabir Lakhi, Anand Moodley, Adrienne K Chan, Joep J. van Oosterhout, Yacouba Njankouo Mapoure, Peter Mwaba, David G. Lalloo, Duolao Wang, Olivier Lortholary, Shabbar Jaffar, Mina C. Hosseinipour, Angela Loyse, Thomas S. Harrison, Tihana Bicanic
Abstract
Abstract Among 472 patients with human immunodeficiency virus-associated cryptococcal meningitis, 16% had severe visual loss at presentation, and 46% of these were 4-week survivors and remained severely impaired. Baseline cerebrospinal fluid opening pressure ≥40 cmH2O (adjusted odds ratio [aOR], 2.56; 95% confidence interval [CI], 1.36–4.83; P = .02) and fungal burden >6.0 log10 colonies/mL (aOR, 3.01; 95% CI, 1.58–5.7; P = .003) were independently associated with severe visual loss.