To the Editor.
—Disseminated Cryptococcus neoformans infection (DCI) is the most common invasive fungal disease and the third most common central nervous system disorder in patients with human immunodeficiency virus (HIV) infection.1 In the United States, as many as 40% of patients with CD4+ cell counts less than 0.10×109/L may be receiving primary antifungal prophylaxis. Because acquisition of infection is by the aerosol route, we questioned the possible association of cryptococcal disease with smoking.As part of the standard HIV evaluation at the Naval Medical Center, San Diego, Calif, patient smoking history is documented routinely. We retrospectively reviewed records of HIV-infected individuals who had CD4+ lymphocyte counts less than 0.10×109
Olson PE, Earhart KC, Rossetti RJ, Newton JA, Wallace MR. Smoking and Risk of Cryptococcosis in Patients With AIDS. JAMA. 1997;277(8):629-630. doi:10.1001/jama.1997.03540320031029