{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:01:46Z","timestamp":1779361306792,"version":"3.51.4"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T00:00:00Z","timestamp":1720396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Eye Institute and Fogarty International Center","award":["R21EY035567"],"award-info":[{"award-number":["R21EY035567"]}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR002492"],"award-info":[{"award-number":["KL2TR002492"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002494"],"award-info":[{"award-number":["UL1TR002494"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23AI138851"],"award-info":[{"award-number":["K23AI138851"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U01AI125003"],"award-info":[{"award-number":["U01AI125003"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Persons with HIV and cryptococcal antigenemia are at high risk of progression to cryptococcal meningitis or death. Baseline cryptococcal antigen (CrAg) plasma titer \u22651:160 is a known risk factor for poor outcomes, but other risk factors are unknown. In HIV-associated cryptococcal meningitis, baseline serum C-reactive protein (CRP) concentrations are positively associated with increased mortality. We hypothesized that CRP might also be associated with meningitis or death in persons with cryptococcal antigenemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We measured plasma CrAg titers and CRP concentrations on cryopreserved serum from prospectively enrolled persons with HIV and cryptococcal antigenemia. Using time-to-event analyses, we compared 24-week meningitis-free survival in persons with normal CRP (&amp;lt;8 mg\/L) and elevated CRP (\u22658 mg\/L). Logistic regression was used to assess how CRP concentration and CrAg titer might interact as covariates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 94 persons with elevated CRP, 19 (20.2%) developed meningitis or death, whereas of the 88 persons with normal CRP, 8 (9.1%) developed meningitis or death (P = .035). Persons with CrAg titer &amp;lt;1:160 and normal CRP had an \u223c5% (3\/61) event rate, whereas those with CrAg titer &amp;lt;1:160 but elevated CRP had an \u223c20% (12\/59) event rate. Importantly, we identified a statistically significant interaction effect between CrAg titer and CRP groups, in which elevated CRP increased risk in the low CrAg titer group (odds ratio, 1.54; 95% confidence interval, 1.16\u20132.04), but this effect was not present in high CrAg titer group (odds ratio, 0.78; 95% confidence interval, .53\u20131.15).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings demonstrate that CrAg titer may modify the direction of effect of CRP with meningitis-free survival; future studies should account for this interaction.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae392","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T04:57:56Z","timestamp":1720414676000},"source":"Crossref","is-referenced-by-count":1,"title":["Baseline C-reactive Protein as a Risk Factor for Cryptococcal Meningitis and Death in HIV-associated Cryptococcal Antigenemia With CrAg Titer as an Effect Modifier"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0000-8876","authenticated-orcid":false,"given":"Caleb P","family":"Skipper","sequence":"first","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"},{"name":"Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Kirumira","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biyue","family":"Dai","sequence":"additional","affiliation":[{"name":"Division of Biostatistics & Health Data Science, School of Public Health, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abduljewad","family":"Wele","sequence":"additional","affiliation":[{"name":"Division of Biostatistics & Health Data Science, School of Public Health, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose","family":"Naluyima","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teopista","family":"Namuli","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fred","family":"Turya","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Muhumuza","sequence":"additional","affiliation":[{"name":"Masaka Field Station, Medical Research Council\/Uganda Virus Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit , Masaka , Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freddie","family":"Kibengo","sequence":"additional","affiliation":[{"name":"Masaka Field Station, Medical Research Council\/Uganda Virus Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit , Masaka , Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R","family":"Boulware","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David B","family":"Meya","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"},{"name":"Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Nalintya","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University , Kampala , Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5531-0231","authenticated-orcid":false,"given":"Radha","family":"Rajasingham","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota , Minneapolis, Minnesota , 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