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M9490752.TXT
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1994-09-24
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Document 0752
DOCN M9490752
TI The role of azoles in the treatment and prophylaxis of cryptococcal
disease in HIV infection.
DT 9411
AU Nelson MR; Fisher M; Cartledge J; Rogers T; Gazzard BG; HIV/GUM unit,
Chelsea & Westminster Hospital, London, UK.
SO AIDS. 1994 May;8(5):651-4. Unique Identifier : AIDSLINE MED/94338601
AB OBJECTIVE: To assess the role of azole therapy in the treatment and
prophylaxis of cryptococcosis in HIV-seropositive individuals. STUDY
DESIGN: Retrospective case review. SETTING: A dedicated HIV unit in
London, UK. PATIENTS: Fifty individuals with a positive cryptococcal
antigen or culture from any site between 1 January 1985 and 31 December
1992. RESULTS: Thirty-eight patients initially presented with meningitis
and 12 with alternative disease, five of whom subsequently developed
meningeal disease. The 12 patients who presented without meningitis
received chronic suppressive therapy after the diagnosis of cryptococcal
disease. Two patients receiving itraconazole developed meningitis as did
three out of four treated with 200 mg fluconazole daily, but none of the
six receiving 400 mg fluconazole daily. Treatment of cryptococcal
meningitis was successful in 17 of the 19 patients given fluconazole but
only three of the six receiving itraconazole. Following successful
treatment of meningitis five out of seven patients given itraconazole
and five out of seven given 200 mg fluconazole daily relapsed compared
with three out of 25 receiving 400 mg fluconazole daily. CONCLUSION:
Fluconazole is an effective treatment for cryptococcal meningitis. For
prophylaxis following meningitis, a dose of 400 mg fluconazole is the
preferred treatment; lower doses are associated with a higher relapse
rate.
DE Amphotericin B/THERAPEUTIC USE AIDS-Related Opportunistic
Infections/*DRUG THERAPY/MORTALITY/ PREVENTION & CONTROL
Cryptococcosis/*DRUG THERAPY/MORTALITY/PREVENTION & CONTROL
Fluconazole/*THERAPEUTIC USE Fungemia/DRUG THERAPY/MORTALITY Human
Itraconazole/*THERAPEUTIC USE London/EPIDEMIOLOGY Meningitis,
Cryptococcal/DRUG THERAPY/MORTALITY/PREVENTION & CONTROL Recurrence
Retrospective Studies Survival Analysis JOURNAL ARTICLE REVIEW
REVIEW, MULTICASE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).