{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:24:32Z","timestamp":1791239072355,"version":"4.1.0"},"reference-count":38,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,5,4]]},"abstract":"<jats:p>Refractory and relapsing crytocococcosis in acquired immune deficiency syndrome (AIDS) patients have a poor prognosis. The risk factors for this complicated infection course were evaluated by comparing refractory and\/or relapsing cryptococcosis in human immunodeficiency virus\u2013coinfected patients (cohort 1) with another group of AIDS patients who adequately responded to antifungals (cohort 2). Except for one isolate of <jats:italic>Cryptococcus gattii<\/jats:italic> from a cohort 2 case, all other isolates were identified as <jats:italic>Cryptococcus neoformans<\/jats:italic> var. <jats:italic>grubii<\/jats:italic>, sex type \u03b1, genotype VNI, including <jats:italic>Cryptococcus<\/jats:italic> reisolated from the relapse or in the refractory state. No differences were observed with respect to <jats:italic>Cryptococcus<\/jats:italic> capsule size and in the melanin and phospholipase production. The cohort 1 patients presented higher prevalence of cryptococcemia, cerebral dissemination, chronic liver disease, and leucopenia, and have increased death rate. Apparently, the refractory and\/or relapsing cryptococcosis in the AIDS patients were more related to the host and the extent of the infection than to the fungal characteristics.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0595","type":"journal-article","created":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T03:34:11Z","timestamp":1456803251000},"page":"975-981","source":"Crossref","is-referenced-by-count":11,"title":["Refractory and\/or Relapsing Cryptococcosis Associated with Acquired Immune Deficiency Syndrome: Clinical Features, Genotype, and Virulence Factors of Cryptococcus spp. Isolates"],"prefix":"10.4269","volume":"94","author":[{"given":"Erika","family":"Nascimento","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia H.","family":"Vitali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludmilla","family":"Tonani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia R. Von Zeska","family":"Kress","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osvaldo M.","family":"Takayanagui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"AIDS","first-page":"525","article-title":"Estimation of the current global burden of cryptococcal meningitis among persons living with HIV\/AIDS","volume":"23","author":"Park","year":"2009"},{"key":"ref2","series-title":"Mycopathologia","first-page":"321","article-title":"Clinical, epidemiological and outcome features of patients with cryptococcosis in Uberaba, Minas Gerais, Brazil","volume":"173","author":"Mora","year":"2012"},{"key":"ref3","series-title":"Clin Microbiol Infect","first-page":"696","article-title":"Microbiological characteristics of clinical isolates of Cryptococcus neoformans in Taiwan: serotypes, mating types, molecular types, virulence factors, and antifungal susceptibility","volume":"16","author":"Liaw","year":"2010"},{"key":"ref4","series-title":"Med Mycol","first-page":"328","article-title":"Correlation of antifungal susceptibility and molecular type within the Cryptococcus neoformans\/C. gattii species complex","volume":"50","author":"Trilles","year":"2012"},{"key":"ref5","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"711","article-title":"Cryptococcus neoformans infection in a cohort of Italian AIDS patients: natural history, early prognostic parameters, and autopsy findings","volume":"20","author":"Antinori","year":"2001"},{"key":"ref6","series-title":"Ann Intern Med","first-page":"176","article-title":"Prognostic factors in cryptococcal meningitis. 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