Cryptic Infection Missed in AIDS Patients

AIDS patients are often misdiagnosed with fungal strain

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) For patients with AIDS, a fungal infection can be a major problem. However, researchers may have found a way to make treatement more likely to succeed by identifying a new cause.

Until now, most doctors will assume AIDS patients with a fungal infection known as cryptococcosis is caused by the strain Cryptococcus neoformans (C. neoformans). A recent study from Duke University Medical Center indicates that a related species, Cryptcoccus gattii (C. gattii) is a likely candidate that causes the fungal infection.

Duke researchers discorvered that over 12 percent of AIDS patients with a cryptococcal infection were infected with C. gattii, where the number was previously thought to be around 1 percent.

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Joseph Heitman, M.D., Ph.D., senior author of the study and chair of the Duke Department of Molecular Genetics and Microbiology reports that the difference in strains makes a difference in treatment decision and clinical outcome. This could mean that there is an unrecognized health burden placed on AIDS patients by C. gattii.

Because cryptococcal strains are responsible for over 620,000 deaths annually and responsible for one-third of all AIDS deaths, this species distinction may be of public health importance.

Dr. Heitman explains a simple blood test could differentiate between the two strains, but even developed countries' labs aren't equipped to distinguish C. gattii and C. neoformans.

Wenjun Li, Ph.D., also a co-lead author and researcher in the Heitman laboratory adds that patients who are infected with the C. gattii strain may be resistant to commonly prescribed "azole" drugs that are used to fight fungal infections. Caregivers need to be aware of this resistance in order to better treat the patient.

John R. Perfect, M.D., professor of medicine at Duke University Medical Center recognizes that this study reveals that AIDS patients in certain areas of the world may be infected by both strains of the fungal infection. Researchers need a better understanding of the two strains of Cryptococcus to improve treatments around the world.

The study is published in September 2011 issue of PLoS Pathogens.

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Review Date: 
August 31, 2011
Last Updated:
September 12, 2011