Most Cases of Cryptococcal Meningitis in HIV-Uninfected Patients in Vietnam Are Due to a Distinct Amplified Fragment Length Polymorphism-Defined Cluster of Cryptococcus neoformans var. grubii VN1

• Published in: Journal of Clinical Microbiology Vol. 49; no. 2; pp. 658 - 664
• Main Authors: Day, Jeremy N, Hoang, Thu N, Duong, Anh V, Hong, Chau T.T, Diep, Pham T, Campbell, James I, Sieu, Tran P.M, Hien, Tran T, Bui, Tien, Boni, Maciej F, Lalloo, David G, Carter, Dee, Baker, Stephen, Farrar, Jeremy J
• Format: Journal Article
• Language: English
• Published: Washington, DC American Society for Microbiology 01-02-2011
• Subjects: Adolescent; Adult; Aged; Amplified Fragment Length Polymorphism Analysis; Biological and medical sciences; Cluster Analysis; Cryptococcus neoformans; Cryptococcus neoformans - classification; Cryptococcus neoformans - genetics; Cryptococcus neoformans - isolation & purification; DNA, Fungal - genetics; Female; Fundamental and applied biological sciences. Psychology; Genotype; HIV Infections - complications; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Meningitis, Cryptococcal - microbiology; Microbiology; Middle Aged; Miscellaneous; Molecular Epidemiology; Mycological Typing Techniques; Mycology; Vietnam; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; South east Asia; Vietnam; Asia; Provence Alpes Côte d'Azur; Europe; Var; France; Immunopathology; Nervous system diseases; Yeast; Cryptococcus neoformans; Tropical zone; AIDS; Immune deficiency; Fungi; Infection; Viral disease; Central nervous system disease; Meningitis; Fungi Imperfecti; Mediterranean region; Amplified fragment length polymorphism marker
• ISSN: 0095-1137; 1098-660X
• DOI: 10.1128/jcm.01985-10

Cryptococcal disease most commonly occurs in patients with an underlying immune deficit, most commonly HIV infection, and is due to Cryptococcus neoformans var. grubii. Occasionally disease due to this variety occurs in apparently immunocompetent patients. The relationship between strains infecting immunosuppressed and immunocompetent patients is not clear. Amplified fragment length polymorphism (AFLP) analysis was used to characterize the relationship between strains infecting HIV-infected and uninfected patients. Isolates from 51 HIV-uninfected patients and 100 HIV-infected patients with cryptococcal meningitis were compared. C. neoformans var. grubii VNI was responsible for infections in 73% of HIV-uninfected and 100% of HIV-infected patients. AFLP analysis defined two distinct clusters, VNIγ and VNIδ. The majority (84%) of isolates from HIV-uninfected patients were VNIγ, compared with only 38% of isolates from HIV-infected patients (odds ratio, 8.30; 95% confidence interval [CI], 3.04 to 26.6; P < 0.0001). In HIV-uninfected patients, underlying disease was less frequent in those with VNIγ infections. Two clusters of C. neoformans var. grubii VN1 are responsible for the majority of cases of cryptococcal meningitis in Vietnam. The distribution of these clusters differs according to the immune status of the host.