Epidemiology of HIV-associated cryptococcosis in France (1985-2001): comparison of the pre- and post-HAART eras

AIDS. 2004 Feb 20;18(3):555-62. doi: 10.1097/00002030-200402200-00024.


Objective: To analyse the epidemiological evolution of cryptococcosis in France after the introduction of highly active antiretroviral therapy (HAART).

Design: Retrospective study of cryptococcosis cases recorded at the National Reference Center for Mycoses in France since 1985.

Methods: Using the national surveillance data, we reviewed 1644 cases of HIV-associated cryptococcosis diagnosed in France (population, 59 million) between 1985 and 2001 and compared them to 335 cases recorded in HIV-negative patients.

Results: The total number of cryptococcosis cases evolved in parallel to that recorded for HIV-infected patients. Changes occurring after HAART introduction were analysed. A negative binomial regression model established a 46% decrease of the incidence of cryptococcosis during the post-HAART era (1997-2001, n = 292) compared to the pre-HAART era (1985-1996, n = 1352). According to multivariate analysis, African origin, older age, heterosexual HIV contamination, no previous AIDS-defining illness, and no previous HIV infection diagnosis were variables independently associated with an increased risk of cryptococcosis during the post-HAART era. During the same period, the characteristics of the HIV-negative population did not change.

Conclusions: Our analysis of the national surveillance identified demographic factors associated with an increased risk of cryptococcosis in the post-HAART era suggesting that failure to consult and considering oneself not at risk were determinant in the current epidemiology of HIV-related cryptococcosis in France.

Publication types

  • Comparative Study

MeSH terms

  • AIDS-Related Opportunistic Infections / epidemiology*
  • Adolescent
  • Adult
  • Antiretroviral Therapy, Highly Active*
  • Child
  • Child, Preschool
  • Cryptococcosis / epidemiology*
  • Epidemiologic Methods
  • Female
  • France / epidemiology
  • HIV Infections / drug therapy
  • Humans
  • Incidence
  • Male
  • Middle Aged