HIV-Associated Cryptococcal Meningitis in Resource-Limited Settings: Current Challenges and Future Developments

Abstract

Cryptococcal meningitis is a severe opportunistic infection in HIV disease. Although the prevalence is declining with the expansion of antiretroviral treatment, it remains an important issue in resource-limited settings. The Cochrane Database of Systematic Reviews, PubMed, EMBASE and AJOL were searched with focus on epidemiology, mycology and pathogenesis, diagnosis and treatment, and challenges in resource-limited settings, and future developments. Challenges particularly in resource-limited settings include inadequate diagnosis due to poor laboratory facilities and low index of suspicion, and poor availability of current effective antifungal drugs. Although studies are still on going on the use of interferon-γ in cryptococcal meningitis, the tempo of research on development of preventive cryptococcal vaccine should also be increased.