Changing epidemiology of HIV-associated cryptococcosis in sub-Saharan Africa

We read with interest the recent dose-finding study by Joshua Rhein and colleagues1 examining the use of sertraline alongside amphotericin B in the treatment of HIV-associated cryptococcal meningitis, and agree that further clinical trials are required to assess the possible benefit of this therapy. As noted in the linked Comment, cryptococcosis has not disappeared following the rollout of antiretroviral therapy (ART); 53% of the participants enrolled in the sertraline study were taking ART, suggesting a change in the epidemiology of HIV-associated cryptococcosis in sub-Saharan Africa during the past 5–10 years.