{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T13:06:32Z","timestamp":1763816792426,"version":"3.45.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5R01NS086312-03","D43TW012266"],"award-info":[{"award-number":["5R01NS086312-03","D43TW012266"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite efforts to optimize therapy for HIV-associated cryptococcal meningitis (CM), survival outcomes remain poor. It is unclear how the cerebrospinal fluid (CSF) cellular immune phenotype and activation contribute to 2-week and 1-year survival following CM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared baseline CSF mononuclear cell phenotype and activation among adults with HIV-associated CM who died within 2 weeks of CM diagnosis to survivors who were alive at 1 year. The activated CSF T lymphocytes, CD14+ monocytes, and CD56+ natural killer cells were determined from freshly collected CSF using Cytek Aurora Spectroflo cytometry. Quantitative CSF soluble cryptococcal antigen (CrAg) titer from frozen CSF at baseline and 1 year was determined using CrAg lateral flow assay. Data were analyzed using STATA version 9.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to survivors, participants who died within 2 weeks had significantly lower absolute CSF CD8+ T cells at baseline. For every 10% increase in PD-1 expression at baseline, the relative risk of 2-week mortality increased by 20%\u201360%. CSF CD14+ monocytes among those who died demonstrated low HLA-DR+ and high CD163+ expression compared to survivors. We noted a significant reduction in the median CSF CrAg titer from 1:2560 at baseline to 1:5 at 1 year (P &amp;lt; .0001) with 8 of 21 (38%) participants testing negative for CSF CrAg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Expression of CD163 on CD14+ macrophages and immune exhaustion of CSF mononuclear cells at baseline are associated with an increased risk of early mortality in CM. After 1 year of treatment, approximately 4 in 10 patients with CM have a negative CSF CrAg.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf449","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T11:55:25Z","timestamp":1755777325000},"page":"1088-1096","source":"Crossref","is-referenced-by-count":0,"title":["Cerebrospinal Fluid Mononuclear Cell Phenotype and Activation Predictors of 2-Week and 1-Year Survival Among Persons With HIV-Associated Cryptococcal Meningitis"],"prefix":"10.1093","volume":"232","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2276-360X","authenticated-orcid":false,"given":"Morris K","family":"Rutakingirwa","sequence":"first","affiliation":[{"name":"Department of Medicine, School of Medicine, College of Health Sciences, Makerere University , Kampala ,","place":["Uganda"]},{"name":"Department of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8125-0698","authenticated-orcid":false,"given":"Kenneth","family":"Ssebambulidde","sequence":"additional","affiliation":[{"name":"Department of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Okurut","sequence":"additional","affiliation":[{"name":"Department of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5270-3539","authenticated-orcid":false,"given":"Richard","family":"Kwizera","sequence":"additional","affiliation":[{"name":"Department of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1727-9813","authenticated-orcid":false,"given":"Martin","family":"Nabwana","sequence":"additional","affiliation":[{"name":"Data Management, Makerere University-John Hopkins University Research Collaboration , Kampala ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0150-4887","authenticated-orcid":false,"given":"Jane","family":"Gakuru","sequence":"additional","affiliation":[{"name":"Department of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3955-8107","authenticated-orcid":false,"given":"Jane Francis","family":"Ndyetukira","sequence":"additional","affiliation":[{"name":"Department of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzan","family":"Mulwana","sequence":"additional","affiliation":[{"name":"Department of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lydia","family":"Nankungu","sequence":"additional","affiliation":[{"name":"Department of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kizza K","family":"Tadeo","sequence":"additional","affiliation":[{"name":"Department of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2410-5344","authenticated-orcid":false,"given":"Abdu K","family":"Musubire","sequence":"additional","affiliation":[{"name":"Department of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4715-0060","authenticated-orcid":false,"given":"David R","family":"Boulware","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota , Minneapolis, Minnesota ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8854-0321","authenticated-orcid":false,"given":"David B","family":"Meya","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of 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