Nationwide Population-Based Epidemiologic Study of Cryptococcal Meningitis in Taiwan

BACKGROUND: Little is known about the epidemiology of cryptococcal meningitis in Taiwan. The aim of this study was to conduct the first nationwide population-based epidemiologic study of cryptococcal meningitis in Taiwan. METHODS: Cases of cryptococcal meningitis were identified from the annual hospitalization discharge claims of the National Health Insurance Research Database with the corresponding ICD-9 code 321.0 from January 2000 to December 2007. RESULTS: A total of 845 incident cases of cryptococcal meningitis were detected. Among them, 109 patients (12.9%) had human immunodeficiency virus (HIV) infection. The average incidence was 4.7 per million person-years. The incidence remarkably increased in the age group of 60-69 years, peaked in the age group of 70-79 years, and fell after the age of 80 years. The average incidence for men was 2.2-fold higher than that for women. The most common complication was obstructive hydrocephalus in 15.3% of the patients, followed by acute respiratory failure in 12.0% of the patients. CONCLUSION: This is the first population-based epidemiologic study of cryptococcal meningitis in Taiwan. The incidence was stable during the study period, and most cases were non-HIV related.