Fungal positivity and other laboratory parameters in HIV- and non-HIV-related cryptococcal meningitis patients upon antifungal treatment

Abstract

The association between fungal positivity in cerebral spinal fluid (CSF) and other laboratory parameters in cryptococcal meningitis (CM) with or without HIV infection is unclear. India ink staining and culture were used to detect the Cryptococcus in the CSF during the treatment course. Hematology analysis and chemistry analysis of CSF were also performed. Flow cytometry was used to analyze the T lymphocyte subsets in the blood. The positivity of the culture reduced significantly faster than that of the ink staining in both HIV and non-HIV patients between treatment time points. The total protein in the CSF of the HIV-related patients was significantly lower than in the non-HIV-related patients at all time points of treatment (p = 0.009, 0.012, 0.001, and 0.037, respectively). The lactate dehydrogenase (LDH) in the CSF of the HIV-related patients at admission was significantly lower than in the non-HIV-related patients (p = 0.017). There were significant differences in glucose and LDH levels between different time points of treatment (p = 0.000 and 0.016, respectively) in the non-HIV-related patients. For Cryptococcus detection in CSF, the culture method appeared to be more sensitive and reliable than the ink staining method. HIV-related CM patients showed certain hematologic and CSF chemistry features which may help guide the management of patients.