{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:13:53Z","timestamp":1781648033882,"version":"3.54.5"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["WT097147MA"],"award-info":[{"award-number":["WT097147MA"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000288","name":"Royal Society","doi-asserted-by":"publisher","award":["100087\/Z\/12\/Z"],"award-info":[{"award-number":["100087\/Z\/12\/Z"]}],"id":[{"id":"10.13039\/501100000288","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UC6-AI058607"],"award-info":[{"award-number":["UC6-AI058607"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We previously observed a substantial burden of cryptococcal meningitis in Vietnam atypically arising in individuals who are uninfected with human immunodeficiency virus (HIV). This disease was associated with a single genotype of Cryptococcus neoformans (sequence type [ST]5), which was significantly less common in HIV-infected individuals. Aiming to compare the phenotypic characteristics of ST5 and non-ST5 C. neoformans, we selected 30 representative Vietnamese isolates and compared their in vitro pathogenic potential and in vivo virulence. ST5 and non-ST5 organisms exhibited comparable characteristics with respect to in vitro virulence markers including melanin production, replication at 37\u00b0C, and growth in cerebrospinal fluid. However, the ST5 isolates had significantly increased variability in cellular and capsular sizing compared with non-ST5 organisms (P\u00a0&amp;lt;\u00a0.001). Counterintuitively, mice infected with ST5 isolates had significantly longer survival with lower fungal burdens at day 7 than non-ST5 isolates. Notably, ST5 isolates induced significantly greater initial inflammatory responses than non-ST5 strains, measured by TNF-\u03b1 concentrations (P\u00a0&amp;lt;\u00a0.001). Despite being generally less virulent in the mouse model, we hypothesize that the significant within strain variation seen in ST5 isolates in the tested phenotypes may represent an evolutionary advantage enabling adaptation to novel niches including apparently immunocompetent human hosts.<\/jats:p>","DOI":"10.1093\/mmy\/myaa013","type":"journal-article","created":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T15:14:41Z","timestamp":1582643681000},"page":"1149-1161","source":"Crossref","is-referenced-by-count":14,"title":["Assessing the virulence of Cryptococcus neoformans causing meningitis in HIV infected and uninfected patients in Vietnam"],"prefix":"10.1093","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4749-6096","authenticated-orcid":false,"given":"Lam Tuan","family":"Thanh","sequence":"first","affiliation":[{"name":"Oxford University Clinical Research Unit, Wellcome Trust Asia Africa Programme, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dena L","family":"Toffaletti","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine and Department of Molecular Genetics and Microbiology, Duke University, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L","family":"Tenor","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine and Department of Molecular Genetics and Microbiology, Duke University, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Giamberardino","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine and Department of Molecular Genetics and Microbiology, Duke University, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory 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Mai","family":"Trinh","sequence":"additional","affiliation":[{"name":"Oxford University Clinical Research Unit, Wellcome Trust Asia Africa Programme, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy E","family":"Thwaites","sequence":"additional","affiliation":[{"name":"Oxford University Clinical Research Unit, Wellcome Trust Asia Africa Programme, Ho Chi Minh City, Vietnam"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip M","family":"Ashton","sequence":"additional","affiliation":[{"name":"Oxford University Clinical Research Unit, Wellcome Trust Asia Africa Programme, Ho Chi Minh City, Vietnam"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Va Vinh","family":"Chau","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen G","family":"Baker","sequence":"additional","affiliation":[{"name":"Cambridge Institute of Therapeutic immunology and Infectious Disease, Department of Medicine, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R","family":"Perfect","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine and Department of Molecular Genetics and Microbiology, Duke University, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7843-6280","authenticated-orcid":false,"given":"Jeremy N","family":"Day","sequence":"additional","affiliation":[{"name":"Oxford University Clinical Research Unit, Wellcome Trust Asia Africa Programme, Ho Chi Minh 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