OBJECTIVE: Rio Grande, in south Rio Grande do Sul, Brazil, is the fourth city of the state ranking in detection and death rates of HIV/AIDS. Given that Cryptococcosis (Cr) is one of the main lethal opportunistic diseases for HIV/AIDS patients, this study aimed to evaluate Cr cases in HIV/AIDS patients treated at the Regional HIV/AIDS Reference Service of the Universitary Hospital (HU) from the Federal University of Rio Grande (FURG) during seven years. This health service covers 27 cities in the south macroregion. METHODS: All cases of HIV/AIDS patients with Cryptococcosis, diagnosed at the Mycology Laboratory from the Medicine Faculty of FURG or at the Clinical Analysis Laboratory of HU-FURG, from 2010 to 2016 were included. It were considered cryptococcosis cases those patients with positive culture, resulting in Cryptococcus sp. isolation, from cerebrospinal fluid (CSF), bronchoalveolar lavage (BAL), pleural fluid (LP) and / or blood, and also patients with titers above 1:8, in serum or CSF, in the latex agglutination test for Cryptococcal antigen. Clinic-epidemiological data from those patients were collected from the databases of the laboratories, medical file services and electronic medical records. The study was approved by the ethics committee of FURG (No. 1,091,685). RESULTS: In the proposed period 70 cases of Cryptococcosis were diagnosed, being the majority of them (72.8%) from the Rio Grande city. The disease was more frequent in men, accounting for 74.3 % (54/70) of the cases and the mean age was 39.9 years (20-78) (SD=11.4). Disseminated cryptococcosis was the most clinical presentation of the disease, corresponding to 61.4% of the cases (43/70), followed by neurocryptococcosis in 28.6% (20/70) and pulmonary cryptococcosis in 10% (7/70). The most frequent symptoms were headache and fever, however, in patients with pulmonary Cr, the predominant symptoms were fever and cough. HIV/AIDS + Cryptococcosis + Tuberculosis (TB) coinfection occurred in 28.6% of the cases studied (20/70), as well as a coinfection with syphilis in 14.3% (10/70), and with hepatitis in 12.9% (9/70), being two patients diagnosed with HIV/AIDS + Cr + TB + Hepatitis C, two cases of HIV/AIDS + Cr + TB + Syphilis and one case of co-infection HIV/AIDS + Cr + Syphilis + Hepatitis C. Cryptococcosis  was the AIDS-defining condition in 40% (28/70) of the patients. The mean CD4 rate was 73 cel / mm³ (SD = 98.8) and viral load ≥50,000 copies was detected in about 75% of the cases. Hospitalization period corresponded to an average of 39.4 days (SD = 31.3), and 14 patients had a recurrence of the disease (20%). Mortality rate was 52.9% (37/70) and life expectancy was on average 81.8 days (2-930) (SD = 168.7) after the first diagnosis of the disease. CONCLUSION: The study evidenced the relevance of HIV / AIDS + Cr co-infection in the HU-FURG Regional HIV / AIDS Reference Service, showing the high prevalence of the disease, the population profile and it poor prognosis.

Cryptococcosis in a Regional HIV/AIDS Reference Service in Southern Brazil