The association of 25-hydroxyvitamin D deficiency with neuroinflammation and prognosis in HIV-negative cryptococcal meningitis.

Qing Tian; Xiaohong Su; Li Xu; Jinchi Liao; Jia Liu; Kai Dai; Ying Jiang; Fuhua Peng; Xiaofeng Xu

doi:10.1016/j.jocn.2026.112206

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The association of 25-hydroxyvitamin D deficiency with neuroinflammation and prognosis in HIV-negative cryptococcal meningitis.

Qing Tian·Xiaohong Su·Li Xu·Jinchi Liao·Jia Liu·Kai Dai·Ying Jiang·Fuhua Peng·Xiaofeng Xu

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Abstract

BACKGROUND: Cryptococcal meningitis (CM) in HIV-negative individuals is increasing, yet the role of vitamin D remains unclear. This study investigates serum 25-hydroxyvitamin D [25(OH)D] levels and their clinical implications in HIV-negative CM patients. METHODS: We conducted a retrospective case-control study of 93 HIV-negative CM patients and 191 healthy controls (HCs). Serum 25(OH)D levels, cerebrospinal fluid (CSF) fungal burden, cytokine profiles, the incidence of postinfectious inflammatory response syndrome (PIIRS), and one-year mortality were assessed. Bivariate logistic regression models identified predictors of mortality. RESULTS: CM patients had significantly lower serum 25(OH)D levels than HCs (18.33 vs. 23.69 ng/mL, p < 0.001), with a higher rate of deficiency (<20 ng/mL) in the CM group (59.14% vs. 34.03%, p < 0.001). Lower 25(OH)D levels were associated with elevated CSF levels of IL-6 and IL-8 (p < 0.05). Deficiency was linked to increased PIIRS incidence (43.64% vs. 21.05%, p = 0.028). Bivariate logistic regression showed a protective trend for 25(OH)D levels (OR 0.939, 95% CI 0.877-1.006, p = 0.075), although deficiency was not associated with higher mortality. CONCLUSIONS: Serum 25(OH)D deficiency is prevalent in HIV-negative CM patients and linked to neuroinflammation and increased risk of PIIRS. Serum 25(OH)D levels may serve as a useful prognostic marker, although further research is needed.

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Humans Meningitis, Cryptococcal Female Male Vitamin D Vitamin D Deficiency Retrospective Studies Prognosis Adult Case-Control Studies Middle Aged Neuroinflammatory Diseases 25-hydroxyvitamin D Cryptococcal meningitis Mortality Postinfectious inflammatory response syndrome Journal Article

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Qing Tian, Xiaohong Su, Li Xu, Jinchi Liao, Jia Liu, Kai Dai, Ying Jiang, Fuhua Peng, Xiaofeng Xu. 2026-07-20. The association of 25-hydroxyvitamin D deficiency with neuroinflammation and prognosis in HIV-negative cryptococcal meningitis.. https://doi.org/10.1016/j.jocn.2026.112206

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Journal Article resource Adult subject Case-Control Studies subject Female subject Humans subject Journal Article subject Male subject Middle Aged subject Mortality subject

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