Olusegun Adesola BUSARI, Olusegun Emmanuel OMOSANYA, Olusogo Ebenezer BUSARI

Kaynakların sınırlı olduğu yerlerde hıv ile birlikte görülen kriptokok menenjiti: Mevcut zorluklar ve gelecekteki gelişmeler

Kriptokok menenjiti HIV hastalığında cidi fırastçı bir enfeksiyondur. Antiviral tedavinin çoğalması ile birlikte prevalansının azalmasına rağmen kaynakların sınırlı olduğu durumlarda önemli bir sorun olarak devam etmektedir. Epidemiyolojiye, mikoloji ve patogeneze, tanı ve tedaviye, kaynakların sınırlı olduğu yerlerdeki güçlüklere ve gelecekteki gelişmelere odaklanılarak The Cochrane Database of Systematic Reviews, PubMed, EMBASE ve AJOL veritabanları taranmıştır. Özellikle kaynakların sınırlı olduğu yerlerdeki zorluklar, zayıf laboratuar imkânlarından ve düşük kuşku indeksinden dolayı yetersiz tanıyı ve var olan etkin anrifungal tedaviye ulaşımın düşük olmasını kapsar. İnterferon-γ kullanımı ile ilgili çalışmalar devam etmekteyse de kriptoko menenjitini önlemek için kriptokok aşısı geliştirme çabaları hızlandırılmalıdır.

[Hiv-associated cryptococcal meningitis in resource-limited settings: Current challenges and future developments]

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-alpha in cryptococcal meningitis, the tempo of research on development of preventive cryptococcal vaccine should also be increased.

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