The Author Replies We greatly appreciate Kobayashi's valuable comment. As mentioned, HIV infection does indeed cause CD4(+) lymphocytopenia and cryptococcosis, and the treatment strategies for cryptococcosis differ between patients with and without HIV infection (1). We performed an HIV test when we found this patient was infected with Cryptococcus and confirmed that the infection status was negative. Therefore, this cryptococcosis patient was not coinfected with HIV. Accordingly, we believe that CD4(+) lymphopenia occurred in this patient due to Daratumumab.
The author states that she has no Conflict of Interest (COI).
References
- 1. Perfect JR, Dismukes WE, Dromer F, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis 50: 291-322, 2010. [DOI] [PMC free article] [PubMed] [Google Scholar]