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ISRN AIDS
Volume 2013 (2013), Article ID 471363, 22 pages
http://dx.doi.org/10.1155/2013/471363
Review Article

New Insights into HIV/AIDS-Associated Cryptococcosis

Department of Biomedical and Clinical Sciences Lvigi Sacco, Università degli Studi di Milano, Via GB Grassi 74, 20157 Milano, Italy

Received 13 December 2012; Accepted 10 January 2013

Academic Editors: C. A. Hughes and B. Joos

Copyright © 2013 Spinello Antinori. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cryptococcal meningitis is a life-threatening opportunistic fungal infection in both HIV-infected and HIV-uninfected patients. According to the most recent taxonomy, the responsible fungus is classified into a complex that contains two species (Cryptococcus neoformans and C. gattii), with eight major molecular types. HIV infection is recognized worldwide as the main underlying disease responsible for the development of cryptococcal meningitis (accounting for 80–90% of cases). In several areas of sub-Saharan Africa with the highest HIV prevalence despite the recent expansion of antiretroviral (ARV) therapy programme, cryptococcal meningitis is the leading cause of community-acquired meningitis with a high mortality burden. Although cryptococcal meningitis should be considered a neglected disease, a large body of knowledge has been developed by several studies performed in recent years. This paper will focus especially on new clinical aspects such as immune reconstitution inflammatory syndrome, advances on management, and strategies for the prevention of clinical disease.