Português

Abstract

Introduction: Cryptococcosis is the main mycosis associated with death from AIDS and the second leading cause of mortality among systemic mycoses. Objective: To describe the clinical and epidemiological profile of cases of people living with HIV (PLWHIV) diagnosed with cryptococcal meningitis, laboratory-confirmed and treated with lipid or conventional formulations of Amphotericin B (AmB), in the induction phase, attended at the Infectious Diseases Reference Hospital and the Public Health Laboratory, located in Goiás, between January 1, 2018 and December 31, 2022. Methodology: Retrospective cross-sectional study based on secondary data obtained from the Infectious Diseases Reference Hospital and the Public Health Laboratory. Results: Of the total number of patients notified (n=94) with cryptococcal meningitis, 78 were eligible for the study. There was a predominance of males, of brown race and the average age was 36.1 years, with no significant association with the year investigated (p>0.05). The majority (73.1%) had a recent HIV diagnosis (<1 year). The CD4+ cell count ranged from 1 to 519 cells/mm3 and the viral load from non-detectable to 4,269,798 copies/mL. As for the species isolated and identified in the culture, 81.5% were C. neoformans. With regard to treatment in the induction phase, 89.7% of the cases used d-AmB and 10.3% used d-AmB associated with lipid formulations. Nephrotoxicity (p<0.05) and hypomagnesemia (p=0.002) were significantly associated with d-AmB treatment. Conclusion Lipid formulations of AmB represent a significant advance in the therapy of this potentially lethal fungal infection, especially in immunosuppressed patients such as PLWHIV.