Cryptococcus neoformans Genotypic Diversity and Disease Outcome among HIV Patients in Africa.

Cryptococcal meningoencephalitis, a disease with poor patient outcomes, remains the most prevalent invasive fungal infection worldwide, accounting for approximately 180,000 deaths each year. In several areas of sub-Saharan Africa with the highest HIV prevalence, cryptococcal meningitis is the leading cause of community-acquired meningitis, with a high mortality among HIV-infected individuals. Recent studies show that patient disease outcomes are impacted by the genetics of the infecting isolate. Yet, there is still limited knowledge of how these genotypic variations contribute to clinical disease outcome. Further, it is unclear how the genetic heterogeneity of C. neoformans and the extensive phenotypic variation observed between and within isolates affects infection and disease. In this review, we discuss current knowledge of how various genotypes impact disease progression and patient outcome in HIV-positive populations in sub-Saharan African, a setting with a high burden of cryptococcosis.

隐球菌性脑膜脑炎是一种患者预后不良的疾病，仍然是全球最常见的侵袭性真菌感染，每年约导致18万人死亡。在撒哈拉以南非洲艾滋病病毒感染率最高的一些地区，隐球菌性脑膜炎是社区获得性脑膜炎的首要病因，在艾滋病病毒感染者中死亡率很高。近期研究表明，感染菌株的遗传学因素会影响患者的疾病预后。然而，对于这些基因型变异如何影响临床疾病预后，人们的了解仍然有限。此外，新型隐球菌的遗传异质性以及菌株之间和菌株内部观察到的广泛表型变异如何影响感染和疾病，目前尚不清楚。在这篇综述中，我们讨论了在隐球菌病负担较重的撒哈拉以南非洲地区，艾滋病病毒阳性人群中各种基因型如何影响疾病进展和患者预后的现有知识。