Fungal burden, early fungicidal activity, and outcome in cryptococcal meningitis in antiretroviral-naive or antiretroviral-experienced patients treated with amphotericin B or fluconazole

被引：202

作者：

Bicanic, Tihana

Meintjes, Graeme

Wood, Robin

Hayes, Madeleine

Rebe, Kevin

Bekker, Linda-Gail

Harrison, Thomas

机构：

[1] Univ London St Georges Hosp, Dept Cellular & Mol Med, Div Infect Dis, London SW17 0RE, England

[2] Desmond Tutu HIV Ctr, Inst Infect Dis & Mol Med, Cape Town, South Africa

[3] Univ Cape Town, Dept Med, ZA-7925 Cape Town, South Africa

[4] GF Jooste Hosp, HIV Serv, Cape Town, South Africa

来源：

CLINICAL INFECTIOUS DISEASES | 2007年 / 45卷 / 01期

基金：

英国医学研究理事会;

关键词：

D O I：

10.1086/518607

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

In a prospective observational study of 54 patients with human immunodeficiency virus-associated cryptococcal meningitis, the early fungicidal activity of amphotericin B ( 1 mg/kg/day) was significantly greater than that of fluconazole ( 400 mg/day). Compared with antiretroviral therapy-naive patients, patients developing cryptococcal meningitis while already receiving antiretroviral therapy had lower baseline fungal burdens and a longer median duration of survival, but there were no differences observed in fungal clearance, cerebrospinal fluid proinflammatory cytokines, or 10-week mortality.

引用

收藏

页码：76 / 80

页数：5

相关论文

共 11 条

[1] Antiretroviral roll-out, antifungal roll-back: access to treatment for cryptococcal meningitis [J].

Bicanic, T ;

Wood, R ;

Bekker, LG ;

Darder, M ;

Meintjes, G ;

Harrison, TS .

LANCET INFECTIOUS DISEASES, 2005, 5 (09) :530-531

[2] Symptomatic relapse of HIV-associated cryptococcal meningitis after initial fluconazole monotherapy: The role of fluconazole resistance and immune reconstitution [J].

Bicanic, Tihana ;

Harrison, Thomas ;

Niepieklo, Alina ;

Dyakopu, Nontobeko ;

Meintjes, Graeme .

CLINICAL INFECTIOUS DISEASES, 2006, 43 (08) :1069-1073

[3] Combination antifungal therapies for HIV-associated cryptococcal meningitis: a randomised trial [J].

Brouwer, AE ;

Rajanuwong, A ;

Chierakul, W ;

Griffin, GE ;

Larsen, RA ;

White, NJ ;

Harrison, TS .

LANCET, 2004, 363 (9423) :1764-1767

[4] Cryptococcocal immune reconstitution disease: a major cause of early mortality in a South African antiretroviral programme [J].

Lawn, SD ;

Bekker, LG ;

Myer, L ;

Orrell, C ;

Wood, R .

AIDS, 2005, 19 (17) :2050-2052

[5] Incidence and risk factors of immune reconstitution inflammatory syndrome complicating HIV-associated cryptococcosis in France [J].

Lortholary, O ;

Fontanet, A ;

Mémain, N ;

Martin, A ;

Sitbon, K ;

Dromer, F .

AIDS, 2005, 19 (10) :1043-1049

[6] Long-term outcome of AIDS-associated cryptococcosis in the era of combination antiretroviral therapy [J].

Lortholary, Olivier ;

Poizat, Gwendoline ;

Zeller, Valerie ;

Neuville, Segolene ;

Oibieux, Andre ;

Alvarez, Muriel ;

Dellarnonica, Pierre ;

Botterel, Francoise ;

Dromer, Francoise ;

Chene, Genevieve .

AIDS, 2006, 20 (17) :2183-2191

[7] Combination therapy with fluconazole and flucytosine for cryptococcal meningitis in Ugandan patients with AIDS [J].

Mayanja-Kizza, H ;

Oishi, K ;

Mitarai, S ;

Yamashita, H ;

Nalongo, K ;

Watanabe, K ;

Izumi, T ;

Ococi-Jungala ;

Augustine, K ;

Mugerwa, R ;

Nagatake, T ;

Matsumoto, K .

CLINICAL INFECTIOUS DISEASES, 1998, 26 (06) :1362-1366

[8] Clinical presentation, natural history, and cumulative death rates of 230 adults with primary cryptococcal meningitis in Zambian AIDS patients treated under local conditions [J].

Mwaba, P ;

Mwansa, J ;

Chintu, C ;

Pobee, J ;

Scarborough, M ;

Portsmouth, S ;

Zumla, A .

POSTGRADUATE MEDICAL JOURNAL, 2001, 77 (914) :769-773

[9] Practice guidelines for the management of cryptococcal disease [J].

Saag, MS ;

Graybill, RJ ;

Larsen, RA ;

Pappas, PG ;

Perfect, JR ;

Powderly, WG ;

Sobel, JD ;

Dismukes, WE .

CLINICAL INFECTIOUS DISEASES, 2000, 30 (04) :710-718

[10]

Shelburne SA, 2005, CLIN INFECT DIS, V40, P1049, DOI 10.1086/428618