%0 Journal Article %T Cryptococcus gattii Species Complex as an Opportunistic Pathogen: Underlying Medical Conditions Associated with the Infection %+ National Institute of Allergy and Infectious Diseases [Bethesda] (NIAID-NIH) %+ National Institutes of Health [Bethesda] (NIH) %+ Johns Hopkins University School of Medicine [Baltimore] %+ Kaiser Permanente %+ National Institute for Communicable Diseases [Johannesburg] (NICD) %+ University of the Witwatersrand [Johannesburg] (WITS) %+ Centers for Disease Control and Prevention (CDC) %+ Institut Pasteur [Paris] (IP) %+ Westmead Hospital [Sydney] %+ The University of Sydney %+ Changzheng Hospital [Shanghai] %+ Duke University [Durham] %A Yang, Dong-Hoon %A England, Matthew %A Salvator, Helene %A Anjum, Seher %A Park, Yoon-Dong %A Marr, Kieren %A Chu, Laurie %A Govender, Nelesh %A Lockhart, Shawn %A Desnos-Ollivier, Marie %A Chen, Sharon %A Halliday, Catriona %A Kan, Alex %A Chen, Jianghan %A Wollenberg, Kurt %A Zelazny, Adrian %A Perfect, John %A Chang, Yun %A Bennett, John %A Holland, Steven %A Meyer, Wieland %A Williamson, Peter %A Kwon-Chung, Kyung %Z This work was supported by the Division of Intramural Research (DIR), NIAID, NIH.Public Health Service Grants (A173896 and A193257) supported the collection of isolates from Botswana by J.R.P. %< avec comité de lecture %@ 2161-2129 %J mBio %I American Society for Microbiology %V 12 %N 5 %P e02708-21 %8 2021-10-26 %D 2021 %R 10.1128/mBio.02708-21 %M 34700378 %K Cryptococcus gattii species complex %K opportunistic pathogen %K anti-GM-CSF autoantibodies %K underlying medical conditions %K molecular epidemiology %Z Life Sciences [q-bio]Journal articles %X The Cryptococcus gattii species complex has often been referred to as a primary pathogen due to its high infection frequency among apparently immunocompetent patients. In order to scrutinize the immune status of patients and the lineages of etiologic agents, we analyzed patient histories and the molecular types of etiologic agents from 135 global C. gattii cases. Eighty-six of 135 patients had been diagnosed as immunocompetent, although some of them had underlying medical issues, and 49 were diagnosed as immunocompromised with risk factors similar to those seen in Cryptococcus neoformans infection. We focused on the 86 apparently immunocompetent patients and were able to obtain plasma from 32 (37%) to analyze for the presence of autoantibodies against the granulocyte-macrophage colony-stimulating factor (GM-CSF) since these antibodies have been reported as a hidden risk factor for C. gattii infection. Among the 32 patients, 25 were free from any known other health issues, and 7 had various medical conditions at the time of diagnosis for cryptococcosis. Importantly, plasma from 19 (76%) of 25 patients with no recognized underlying medical condition showed the presence of GM-CSF autoantibodies, supporting this antibody as a major hidden risk factor for C. gattii infection. These data indicate that seemingly immunocompetent people with C. gattii infection warrant detailed evaluation for unrecognized immunologic risks. There was no relationship between molecular type and underlying conditions of patients. Frequency of each molecular type was related to its geographic origin exemplified by the overrepresentation of VGIV in HIV-positive (HIV+) patients due to its prevalence in Africa. %G English %2 https://pasteur.hal.science/pasteur-04066261/document %2 https://pasteur.hal.science/pasteur-04066261/file/mBio.02708-21.pdf %L pasteur-04066261 %U https://pasteur.hal.science/pasteur-04066261 %~ PASTEUR