- The late mortality rate from cryptococcosis remains ~50% among people living with HIV (PLWH).
- Mortality is higher among individuals who are not virologically suppressed, and those with surrogate markers for low socioeconomic status.
Why this matters
- Mortality risk remains high >90 days postcryptococcal infection diagnosis.
- Close follow-up, efforts to address virological suppression may help improve outcomes.
- 105 PLWH with cryptococcosis.
- Overall mortality was 47.6% (n=50) over a median follow-up of 3.7 (interquartile range [IQR], 1.1-8.1) years.
- Median postcryptococcosis diagnosis survival was 244 (IQR, 43-1167) days.
- Mortality was higher among individuals diagnosed before the advent of modern antiretroviral therapy (ART: HR, 2.2; 95% CI, 1.2-4.3; P=.014).
- Late mortality was higher among individuals diagnosed before the modern ART era (48% vs 12%, P<.001>
- Late mortality (97%, n=32) was associated with HIV+ status at diagnosis (P=.003 vs survivors), lower rates of viral suppression (P=.001 vs survivors), and government insurance (88%, n=29; P=.008 vs survivors).
- Logistic regression: HIV viral load suppressed at last observation (P=.033), insurance provider (P=.042), ART treatment era (P=.002) remained significantly associated with late mortality.
- Retrospective cohort study evaluating cryptococcosis-related mortality in PLWH.
- Funding: NIH.
- Length-time bias.
- Omission errors.