Journal Article

The Changing Epidemiology of Cryptococcosis: An Update from Population-Based Active Surveillance in 2 Large Metropolitan Areas, 1992–2000

Sara A. Mirza, Maureen Phelan, David Rimland, Edward Graviss, Richard Hamill, Mary E. Brandt, Tracie Gardner, Matthew Sattah, Gabriel Ponce de Leon, Wendy Baughman and Rana A. Hajjeh

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 36, issue 6, pages 789-794
Published in print March 2003 | ISSN: 1058-4838
Published online March 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/368091
The Changing Epidemiology of Cryptococcosis: An Update from Population-Based Active Surveillance in 2 Large Metropolitan Areas, 1992–2000

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To examine trends in the incidence and epidemiology of cryptococcosis, active, population-based surveillance was conducted during 1992–2000 in 2 areas of the United States (the Atlanta, Georgia, and Houston, Texas, metropolitan areas; combined population, 7.4 million). A total of 1491 incident cases were detected, of which 1322 (89%) occurred in HIV-infected persons. The annual incidence of cryptococcosis per 1000 persons with AIDS decreased significantly during the study period, from 66 in 1992 to 7 in 2000 in the Atlanta area, and from 24 in 1993 to 2 in 2000 in the Houston area. Poisson regression analysis revealed that African American persons with AIDS were more likely than white persons with AIDS to develop disease. Less than one-third of all HIV-infected persons with cryptococcosis were receiving antiretroviral therapy before diagnosis. Our findings suggest that HIV-infected persons who continue to develop cryptococcosis in the era of highly active antiretroviral therapy (HAART) in the United States are those with limited access to health care. More efforts are needed to expand the availability of HAART and routine HIV care services to these persons.

Journal Article.  3756 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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