The status of cryptococcosis in Latin America

Abstract

Cryptococcosis is a life-threatening fungal infection caused by the encapsulated yeasts Cryptococcus neoformans and C. gattii, acquired from the environment. In Latin America, as occurring worldwide, C. neoformans causes more than 90% of the cases of cryptococcosis, affecting predominantly patients with HIV, while C. gattii generally affects otherwise healthy individuals. In this region, cryptococcal meningitis is the most common presentation, with amphotericin B and fluconazole being the antifungal drugs of choice. Avian droppings are the predominant environmental reservoir of C. neoformans, while C. gattii is associated with several arboreal species. Importantly, C. gattii has a high prevalence in Latin America and has been proposed to be the likely origin of some C. gattii populations in North America. Thus, in the recent years, significant progress has been made with the study of the basic biology and laboratory identification of cryptococcal strains, in understanding their ecology, population genetics, host-pathogen interactions, and the clinical epidemiology of this important mycosis in Latin America.

17‐β‐Estradiol increases macrophage activity through activation of the G‐protein‐coupled estrogen receptor and improves the response of female mice to Cryptococcus gattii

“…Furthermore, previous studies have demonstrated that testosterone has multiple depressive effects on the immune system (McClelland et al, ; Pennell, Galligan, & Fish, ; Pinzan, Ruas, Casabona‐Fortunato, Carvalho, & Roque‐Barreira, ). These results support epidemiological data that indicate the higher occurrence rate of this disease in males (Firacative et al, ; Shaheen et al, ).…”

“…In a most recent large series of autopsies carried out in the low‐income countries, Mozambique and Brazil, over 40% of patients with cryptococcosis were immunocompetent (Hurtado et al, ). Among non‐HIV‐infected patients in Latin America, C. gattii VGII is reported as the main agent; in both HIV‐infected and non‐infected populations, most cases of cryptococcosis are reported in young males (Firacative, Lizarazo, Illnait‐Zaragozí, Castañeda, & Latin American Cryptococcal Study Group, ; Shaheen, Somayaji, Myers, & Mody, ).…”

Glucuronoxylomannan in theCryptococcusspecies capsule as a target for CAR+T-cell therapy

“…The currently available antifungal drugs used to combat cryptococcosis consist of a combination of amphotericin B deoxycholate or liposomal amphotericin B and 5-fluorocytosine administered for 2 weeks. Fluconazole is recommended for use during the consolidation and maintenance phases, but this antifungal drug requires a long treatment course, which reduces patient compliance and/or tolerability [30, 31]. The treatments of cryptococcosis and other invasive fungal infections should display rapid fungicidal activity and completely eliminate the fungus from the host system.…”

Cryptococcal antigenemia and its predictors among HIV infected patients in resource limited settings: a systematic review

“…Despite the high burden of cryptococcal meningitis related morbidity and mortality in resource limited settings, reviewed data on magnitude of cryptococcal antigenemia and its predictors is missing [22,23]. Hence, data is required on this field to inform policy makers for input to tailor intervention measures.…”