Epidemiological and Clinical Profile and Management of Neuromeningeal Cryptococcosis in People Living with HIV in Kinshasa: Case of N’Djili General Reference Hospital

Abstract

Background: Neuromeningeal Cryptococcosis (NMC) is the most common systemic mycosis observed during infection with Human Immunodeficiency Virus (HIV); it is a very common opportunistic infection in an immunecompromised panel of advanced stage HIV infection. Objective: The objective is to determine the epidemiological and clinical profile of Neuromeningeal Cryptococcosis in People Living with HIV (PLHIV) in Kinshasa. Methods: It is a retrospective study based on the files of PLHIV with NMC followed at the Department of Internal Medicine at N'Djili General Hospital from January 2016 to December 2019. All files of PLHIV, without any discrimination, followed in the center in the selected period, duly completed, with a confirmed positive diagnosis for NMC were retained for the study. Data were collected from the patient register and patient medical records with respect for anonymity and confidentiality. Results: 94 cases of PLHIV with NMC were retained in compliance with the inclusion criteria, of which 64 are men (68.1%). The most represented age group was that of 35 to 40 years with 25 patients (26.59%), followed by that of 30 to 35 years (21.27%). The most frequent clinical signs at the start of treatment were: headache (20.21%), convulsion and photophobia (17.02%), and memory impairment (13.82%). Only 89.4% had a positive China's ink exam on cerebrospinal fluid. The most used medication was amphotericin B (42.55%), followed by fluconazole (31.91%).