{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T15:55:43Z","timestamp":1784908543760,"version":"3.55.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T00:00:00Z","timestamp":1719619200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"US National Institute of Neurologic Disorders & Stroke","award":["K23NS122601"],"award-info":[{"award-number":["K23NS122601"]}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["R01NS086312"],"award-info":[{"award-number":["R01NS086312"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43TW009345"],"award-info":[{"award-number":["D43TW009345"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["K01TW010268"],"award-info":[{"award-number":["K01TW010268"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["T32AI055433"],"award-info":[{"award-number":["T32AI055433"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Wellcome Trust Clinical PhD Fellowship","award":["203905\/Z\/16\/Z"],"award-info":[{"award-number":["203905\/Z\/16\/Z"]}]},{"name":"United Kingdom Medical Research Council","award":["MR\/M007413\/1"],"award-info":[{"award-number":["MR\/M007413\/1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Mortality among adults diagnosed with HIV-associated cryptococcal meningitis remains high (24%\u201340%). We hypothesized that nutritional state, as measured by mid\u2013upper arm circumference (MUAC), is a potentially modifiable risk factor for mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Ugandan adults hospitalized with HIV-associated cryptococcal meningitis had MUAC measurements performed at baseline. We compared MUAC measurements with baseline clinical and demographic variables and investigated associations with survival using Cox regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 433 participants enrolled, 41% were female, the median CD4 T-cell count (interquartile range [IQR]) was 15 (6\u201341) cells\/\u03bcL, and 37% were antiretroviral therapy na\u00efve. The median MUAC (IQR) was 24 (22\u201326) cm, the median weight (IQR) was 53 (50\u201360) kg, and MUAC correlated with weight (Pearson r = 0.6; P &amp;lt; .001). Overall, 46% (200\/433) died during the 18-week follow-up. Participants in the lowest MUAC quartile (\u226422 cm) had the highest mortality: 39% (46\/118) at 2 weeks and 62% (73\/118) at 18 weeks. A baseline MUAC \u226422 cm was associated with an 82% increased risk of 18-week mortality as compared with participants with an MUAC &amp;gt;22 cm (unadjusted hazard ratio, 1.82; 95% CI, 1.36\u20132.42; P &amp;lt; .001). Following adjustment for antiretroviral therapy status, CD4 count, hemoglobin, amphotericin dose, and tuberculosis status, the adjusted hazard ratio was 1.84 (95% CI, 1.27\u20132.65; P &amp;lt; .001). As a continuous variable, 18-week mortality was reduced by 10% for every 1-cm increase in MUAC. CSF Th17 immune responses were positively associated with MUAC quartile.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>MUAC measurement is a simple bedside tool that can identify adults with HIV-associated cryptococcal meningitis at high risk for mortality for whom an enhanced bundle of care, including nutritional supplementation, should be further investigated.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae354","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T15:50:49Z","timestamp":1719417049000},"source":"Crossref","is-referenced-by-count":2,"title":["Mid\u2013Upper Arm Circumference Is a Strong Predictor of Mortality Among Ugandan Adults With HIV-Associated Cryptococcal Meningitis: A Prospective Cohort Study"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2705-108X","authenticated-orcid":false,"given":"Gila","family":"Hale","sequence":"first","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Adzemovic","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"},{"name":"Department of Medicine, Brigham and Women\u2019s Hospital , Boston, Massachusetts , USA"},{"name":"Department of Pediatrics, Boston Children\u2019s Hospital , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Huppler Hullsiek","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzan","family":"Mulwana","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane Francis","family":"Ndyetukira","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisat","family":"Sadiq","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mable","family":"Kabahubya","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , 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Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Menya","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Nakitto","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conrad","family":"Muzoora","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mbarara University of Science and Technology , Mbarara , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Nuwagira","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mbarara University of Science and Technology , Mbarara , 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