# Cryptococcosis in Colombia: Analysis of Data from Laboratory-Based Surveillance 2017–2024

## TL;DR

This study analyzes cryptococcosis cases in Colombia from 2017–2024, showing higher rates in HIV-positive individuals and changes in the disease's epidemiology.

## Contribution

The study provides updated epidemiological data on cryptococcosis in Colombia, highlighting shifts in risk factors and patient demographics.

## Key findings

- Cryptococcosis incidence was 0.22 per 100,000 people overall, with much higher rates in HIV-positive individuals.
- Neurocryptococcosis was the most common form of the disease, and Cryptococcus neoformans was the most frequently identified species.
- The study observed a decline in HIV-related cases and an increase in cases among older adults with other immunosuppressive conditions.

## Abstract

Since 1997, a laboratory-based survey on cryptococcosis has been conducted in Colombia. We present the results for the period 2017–2024. A total of 891 surveys were received. The overall incidence was 0.22 cases per 100,000 people. Among those living with HIV, the incidence was 38, and among HIV-negative people, it was 0.08. Cryptococcosis demonstrated a higher prevalence among men than women (3.2:1). Among patients living with Human Immunodeficiency Virus (HIV), the condition primarily affected younger adults (26–40 years). In contrast, among HIV-negative people, it was mostly observed in older adults (≥60 years). HIV infection was the most significant risk factor (63%), but another cause of immunosuppression was identified in 21.2% cases. Neurocryptococcosis was the most common form of presentation (62.2%), followed by disseminated cryptococcosis (31.1%). The diagnosis was confirmed by culture in 99.4% of patients; the most important sample was cerebrospinal fluid (67.3%), followed by blood (35.4%). Cryptococcus neoformans was identified in 93.1% of cases, and Cryptococcus gatti in 6.9%. Predominant molecular patterns were VNI (92.4%) and VGII (45.3%). The epidemiology of cryptococcosis in Colombia is changing, with a progressive decrease in HIV coinfection and an increase in other immunosuppressive conditions in older people. This study highlights the importance of cryptococcosis in Colombia and the need to report it in order to improve knowledge and thereby promote the quality of diagnosis and the opportunity for more effective treatment.