The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Olivier Lortholary - One of the best experts on this subject based on the ideXlab platform.
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lipid formulations of amphotericin b significantly improve outcome in solid organ transplant recipients with central nervous system Cryptococcosis
Clinical Infectious Diseases, 2009Co-Authors: Hsinyun Sun, Jyoti Somani, Graeme N. Forrest, Francoise Dromer, Olivier Lortholary, Barbara D. Alexander, Marshall G Lyon, Krishan Lal Gupta, Ramon Del BustoAbstract:Synergistic interactions were observed between CIs and antifungal agents against 53 (90%) of 59 Cryptococcus neoformans isolates from solid organ transplant recipients with Cryptococcosis and may account for better outcomes in patients with Cryptococcosis receiving these immunosuppressive agents.
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Cryptococcosis in solid organ transplant recipients current state of the science
Clinical Infectious Diseases, 2008Co-Authors: Nina Singh, Francoise Dromer, Olivier Lortholary, John R. PerfectAbstract:Cryptococcosis remains a significant opportunistic infection in solid organ transplant recipients. Disease presentation and outcomes may be affected by, among other factors, the use of calcineurin inhibitor immunosuppressive agents. It is being increasingly recognized that rapid reversal of immunosuppression in transplant recipients treated for Cryptococcosis incurs the risk of immune reconstitution inflammatory syndrome, which resembles worsening disease or relapse. This review summarizes the current state of knowledge regarding Cryptococcosis in transplant recipients and highlights areas where future investigations are needed to further optimize outcomes for these patients.
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calcineurin inhibitor agents interact synergistically with antifungal agents in vitro against cryptococcus neoformans isolates correlation with outcome in solid organ transplant recipients with Cryptococcosis
Antimicrobial Agents and Chemotherapy, 2008Co-Authors: Dimitrios P. Kontoyiannis, Francoise Dromer, Olivier Lortholary, Barbara D. Alexander, Krishan Lal Gupta, Ramon Del Busto, Russell E Lewis, George John, Goran B Klintmalm, Jyoti SomaniAbstract:Synergistic interactions were observed between CIs and antifungal agents against 53 (90%) of 59 Cryptococcus neoformans isolates from solid organ transplant recipients with Cryptococcosis and may account for better outcomes in patients with Cryptococcosis receiving these immunosuppressive agents.
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incidence and risk factors of immune reconstitution inflammatory syndrome complicating hiv associated Cryptococcosis in france
AIDS, 2005Co-Authors: Olivier Lortholary, Arnaud Fontanet, N Memain, Antoine Martin, Karine Sitbon, Francoise DromerAbstract:Background: Immune reconstitution inflammatory syndrome (IRIS) in association with Cryptococcosis has been anecdotically reported following administration of highly active antiretroviral therapy (HAART). Objective: To analyse the incidence and risk factors for IRIS-associated Cryptococcosis among HIV-infected patients. Design: Retrospective multicentre study between 1996 and 2000 through the French Cryptococcosis Database. Methods: Subsequent occurrence of IRIS examined in 120 HIV-infected adult patients treated with HAARTand experiencing a first episode of culture-confirmed Cryptococcosis. Results: Ten patients developed IRIS during the study period, giving an incidence of 10/239, or 4.2/100 person-years [95% confidence interval (Cl), 2.2-7.8]. IRIS consisted of acute symptoms consistent with inflammation occurring within a median of 8 months (range, 2 -3 7) after the diagnosis of Cryptococcosis in the context of negative cultures and immunological and/or virological response to HAART. Radiology and histopathology detected features compatible with inflammation. Symptom severity required transfer into intensive care units for three patients and use of anti-inflammatory drugs for four. Three patients with evolutive IRIS died. Compared with patients without IRIS for whom complete clinical and microbiological information were available at baseline, previously unknown HIV infection [odds ratio (OR), 4.8; 95% Cl, 1.0-21.7], CD4 cell count < 7 x 106 cells/I (OR, 4.0; 95% CI, 0.9-17.2), fungaemia (OR, 6.1; 95% Cl, 1.1-35.2) and HAART initiation within 2 months of Cryptococcosis diagnosis (OR, 5.50; 95% CI, 1.0-29.6) were independently associated with the risk of subsequent IRIS. Conclusions: IRIS-related Cryptococcosis was observed more frequently in severely immunocompromised patients with disseminated infection and HAART initiation soon after the diagnosis.
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epidemiology of hiv associated Cryptococcosis in france 1985 2001 comparison of the pre and post haart eras
AIDS, 2004Co-Authors: Francoise Dromer, Simone Mathoulinpelissier, Arnaud Fontanet, Olivier Ronin, B Dupont, Olivier LortholaryAbstract:Objective: To analyse the epidemiological evolution of Cryptococcosis in France after the introduction of highly active antiretroviral therapy (HAART). Design: Retrospective study of Cryptococcosis cases recorded at the National Reference Center for Mycoses in France since 1985. Methods: Using the national surveillance data, we reviewed 1644 cases of HIV-associated Cryptococcosis diagnosed in France (population, 59 million) between 1985 and 2001 and compared them to 335 cases recorded in HIV-negative patients. Results: The total number of Cryptococcosis cases evolved in parallel to that recorded for HIV-infected patients. Changes occurring after HAART introduction were analysed. A negative binomial regression model established a 46% decrease of the incidence of Cryptococcosis during the post-HAART era (1997-2001, n = 292) compared to the pre-HAART era (1985-1996, n = 1352). According to multivariate analysis, African origin, older age, heterosexual HIV contamination, no previous AIDS-defining illness, and no previous HIV infection diagnosis were variables independently associated with an increased risk of Cryptococcosis during the post-HAART era. During the same period, the characteristics of the HIV-negative population did not change. Conclusions: Our analysis of the national surveillance identified demographic factors associated with an increased risk of Cryptococcosis in the post-HAART era suggesting that failure to consult and considering oneself not at risk were determinant in the current epidemiology of HIV-related Cryptococcosis in France.
Francoise Dromer - One of the best experts on this subject based on the ideXlab platform.
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lipid formulations of amphotericin b significantly improve outcome in solid organ transplant recipients with central nervous system Cryptococcosis
Clinical Infectious Diseases, 2009Co-Authors: Hsinyun Sun, Jyoti Somani, Graeme N. Forrest, Francoise Dromer, Olivier Lortholary, Barbara D. Alexander, Marshall G Lyon, Krishan Lal Gupta, Ramon Del BustoAbstract:Synergistic interactions were observed between CIs and antifungal agents against 53 (90%) of 59 Cryptococcus neoformans isolates from solid organ transplant recipients with Cryptococcosis and may account for better outcomes in patients with Cryptococcosis receiving these immunosuppressive agents.
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Cryptococcosis in solid organ transplant recipients current state of the science
Clinical Infectious Diseases, 2008Co-Authors: Nina Singh, Francoise Dromer, Olivier Lortholary, John R. PerfectAbstract:Cryptococcosis remains a significant opportunistic infection in solid organ transplant recipients. Disease presentation and outcomes may be affected by, among other factors, the use of calcineurin inhibitor immunosuppressive agents. It is being increasingly recognized that rapid reversal of immunosuppression in transplant recipients treated for Cryptococcosis incurs the risk of immune reconstitution inflammatory syndrome, which resembles worsening disease or relapse. This review summarizes the current state of knowledge regarding Cryptococcosis in transplant recipients and highlights areas where future investigations are needed to further optimize outcomes for these patients.
-
calcineurin inhibitor agents interact synergistically with antifungal agents in vitro against cryptococcus neoformans isolates correlation with outcome in solid organ transplant recipients with Cryptococcosis
Antimicrobial Agents and Chemotherapy, 2008Co-Authors: Dimitrios P. Kontoyiannis, Francoise Dromer, Olivier Lortholary, Barbara D. Alexander, Krishan Lal Gupta, Ramon Del Busto, Russell E Lewis, George John, Goran B Klintmalm, Jyoti SomaniAbstract:Synergistic interactions were observed between CIs and antifungal agents against 53 (90%) of 59 Cryptococcus neoformans isolates from solid organ transplant recipients with Cryptococcosis and may account for better outcomes in patients with Cryptococcosis receiving these immunosuppressive agents.
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incidence and risk factors of immune reconstitution inflammatory syndrome complicating hiv associated Cryptococcosis in france
AIDS, 2005Co-Authors: Olivier Lortholary, Arnaud Fontanet, N Memain, Antoine Martin, Karine Sitbon, Francoise DromerAbstract:Background: Immune reconstitution inflammatory syndrome (IRIS) in association with Cryptococcosis has been anecdotically reported following administration of highly active antiretroviral therapy (HAART). Objective: To analyse the incidence and risk factors for IRIS-associated Cryptococcosis among HIV-infected patients. Design: Retrospective multicentre study between 1996 and 2000 through the French Cryptococcosis Database. Methods: Subsequent occurrence of IRIS examined in 120 HIV-infected adult patients treated with HAARTand experiencing a first episode of culture-confirmed Cryptococcosis. Results: Ten patients developed IRIS during the study period, giving an incidence of 10/239, or 4.2/100 person-years [95% confidence interval (Cl), 2.2-7.8]. IRIS consisted of acute symptoms consistent with inflammation occurring within a median of 8 months (range, 2 -3 7) after the diagnosis of Cryptococcosis in the context of negative cultures and immunological and/or virological response to HAART. Radiology and histopathology detected features compatible with inflammation. Symptom severity required transfer into intensive care units for three patients and use of anti-inflammatory drugs for four. Three patients with evolutive IRIS died. Compared with patients without IRIS for whom complete clinical and microbiological information were available at baseline, previously unknown HIV infection [odds ratio (OR), 4.8; 95% Cl, 1.0-21.7], CD4 cell count < 7 x 106 cells/I (OR, 4.0; 95% CI, 0.9-17.2), fungaemia (OR, 6.1; 95% Cl, 1.1-35.2) and HAART initiation within 2 months of Cryptococcosis diagnosis (OR, 5.50; 95% CI, 1.0-29.6) were independently associated with the risk of subsequent IRIS. Conclusions: IRIS-related Cryptococcosis was observed more frequently in severely immunocompromised patients with disseminated infection and HAART initiation soon after the diagnosis.
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epidemiology of hiv associated Cryptococcosis in france 1985 2001 comparison of the pre and post haart eras
AIDS, 2004Co-Authors: Francoise Dromer, Simone Mathoulinpelissier, Arnaud Fontanet, Olivier Ronin, B Dupont, Olivier LortholaryAbstract:Objective: To analyse the epidemiological evolution of Cryptococcosis in France after the introduction of highly active antiretroviral therapy (HAART). Design: Retrospective study of Cryptococcosis cases recorded at the National Reference Center for Mycoses in France since 1985. Methods: Using the national surveillance data, we reviewed 1644 cases of HIV-associated Cryptococcosis diagnosed in France (population, 59 million) between 1985 and 2001 and compared them to 335 cases recorded in HIV-negative patients. Results: The total number of Cryptococcosis cases evolved in parallel to that recorded for HIV-infected patients. Changes occurring after HAART introduction were analysed. A negative binomial regression model established a 46% decrease of the incidence of Cryptococcosis during the post-HAART era (1997-2001, n = 292) compared to the pre-HAART era (1985-1996, n = 1352). According to multivariate analysis, African origin, older age, heterosexual HIV contamination, no previous AIDS-defining illness, and no previous HIV infection diagnosis were variables independently associated with an increased risk of Cryptococcosis during the post-HAART era. During the same period, the characteristics of the HIV-negative population did not change. Conclusions: Our analysis of the national surveillance identified demographic factors associated with an increased risk of Cryptococcosis in the post-HAART era suggesting that failure to consult and considering oneself not at risk were determinant in the current epidemiology of HIV-related Cryptococcosis in France.
David R. Andes - One of the best experts on this subject based on the ideXlab platform.
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Primary cutaneous Cryptococcosis in immunocompetent and immunocompromised hosts
Medical mycology, 2003Co-Authors: John C. Christianson, William D. Engber, David R. AndesAbstract:A case of primary cutaneous cryptococcal infection is presented and cases of primary cutaneous Cryptococcosis in normal and immunocompromised hosts are reviewed. Cutaneous Cryptococcosis can occur from local inoculation or dissemination from a distant site of infection. Risk factors associated with development of primary cutaneous Cryptococcosis are those which affect cell-mediated immunity, such as corticosteroid usage, solid organ transplantation, sarcoidosis and immunosuppression. The cutaneous manifestations of Cryptococcosis are protean and may mimic other cutaneous diseases. Patients with a diagnosis of Cryptococcosis from a skin biopsy or culture should undergo evaluation to exclude disseminated disease and an evaluation of cell-mediated immunity. Although some patients do well without antifungal therapy, these patients cannot be discerned prospectively and therefore antifungal therapy appears warranted in all patients with localized disease. Choice of therapy depends on the extent of disease and immunocompetence of the host.
Nanshan Zhong - One of the best experts on this subject based on the ideXlab platform.
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retrospective analysis of 76 immunocompetent patients with primary pulmonary Cryptococcosis
Lung, 2012Co-Authors: Jiaxing Xie, Qingsi Zeng, Guoqin Chen, Shuqing Zhong, Nanshan ZhongAbstract:Background Pulmonary Cryptococcosis typically occurs in immunocompromised patients, but it can also occur in immunocompetent patients. Our objective was to describe the clinical manifestations, diagnosis, and management of primary pulmonary Cryptococcosis in immunocompetent patients.
Shichina Kannambath - One of the best experts on this subject based on the ideXlab platform.
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genome wide association study identifies novel colony stimulating factor 1 locus conferring susceptibility to Cryptococcosis in human immunodeficiency virus infected south africans
Open Forum Infectious Diseases, 2020Co-Authors: Shichina Kannambath, Joseph N Jarvis, Rachel M Wake, Nicky Longley, Angela Loyse, Vicky Matzaraki, Raul AguirregamboaAbstract:Background. Cryptococcus is the most common cause of meningitis in human immunodeficiency virus (HIV)-infected Africans. Despite universal exposure, only 5%-10% of patients with HIV/acquired immune deficiency syndrome and profound CD4(+) T-cell depletion develop disseminated Cryptococcosis: host genetic factors may play a role. Prior targeted immunogenetic studies in Cryptococcosis have comprised few Africans. Methods. We analyzed genome-wide single-nucleotide polymorphism (SNP) genotype data from 524 patients of African descent: 243 cases (advanced HIV with cryptococcal antigenemia and/or cryptococcal meningitis) and 281 controls (advanced HIV, no history of Cryptococcosis, negative serum cryptococcal antigen). Results. Six loci upstream of the colony-stimulating factor 1 (CSF1) gene, encoding macrophage colony-stimulating factor (M-CSF) were associated with susceptibility to Cryptococcosis at P <10(-6) and remained significantly associated in a second South African cohort (83 cases; 128 controls). Meta-analysis of the genotyped CSF1 SNP rs1999713 showed an odds ratio for Cryptococcosis susceptibility of 0.53 (95% confidence interval, 0.42-0.66; P = 5.96 x 10(-8)). Ex vivo functional validation and transcriptomic studies confirmed the importance of macrophage activation by M-CSF in host defence against Cryptococcus in HIV-infected patients and healthy, ethnically matched controls. Conclusions. This first genome-wide association study of susceptibility to Cryptococcosis has identified novel and immunologically relevant susceptibility loci, which may help define novel strategies for prevention or immunotherapy of HIV-associated cryptococcal meningitis.