CRYPTOCOCCOSIS IN HIV-INFECTION OF MAN - AN EPIDEMIOLOGIC AND IMMUNOLOGICAL INDICATOR

Cryptococcosis is an epidemiological and immunological indicator due t o the absence of Cryptococcus neoformans as a saprophyte in immunocomp etent humans and the advantage of specific C. neoformans culture. On t his basis, a report is presented on the CD4 lymphocyte count of 36 AID S patients suffering from cryptococcosis and other concomitant or miss ing opportunistic AIDS-defining infections. In 26 out of 36 patients, i. e. 72%, a CD4 lymphocyte count of less than or equal to 50/mu L (me an value 39.5%) was found. Cryptococcosis as the sole opportunistic in fection was diagnosed in 5 cases (13.9%). In 31 cases, various combina tions of AIDS-associated diseases were found: Pneumocystis carinii pne umonia (PCP) (n = 19), cytomegalovirus infection (CMV) (n = 10), Kapos i's sarcoma (n = 6), Mycobacterium avium intracellulare infection (MAI ) (n = 5), pneumonia (n = 2), toxoplasmosis (n = 2), Candida esophagit is (n = 1), tuberculosis (n = 1), lambliasis (n = 1), salmonellosis (n = 1) and wasting syndrome (n = 5). The conspicuous simultaneous occur rence or succession of pneumocystosis and cryptococcosis and the contr asting absence of aspergillosis and mucormycosis (zygomycosis) are com mented. Based on the present observations in HIV-infected persons in B erlin, a CD4 lymphocyte count of < 150/mu L may be used as a parameter indicating a predisposition for cryptococcosis as an airborne AIDS-de fining infection. Attention is drawn to bird droppings as the sole hab itat of C. neoformans and accidental niche of various other microorgan isms.