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M94A0329.TXT
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1994-10-08
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Document 0329
DOCN M94A0329
TI Measurement of cryptococcal antigen in serum and cerebrospinal fluid:
value in the management of AIDS-associated cryptococcal meningitis.
DT 9412
AU Powderly WG; Cloud GA; Dismukes WE; Saag MS; Division of Infectious
Diseases, Washington University School of; Medicine, St. Louis, Missouri
63110.
SO Clin Infect Dis. 1994 May;18(5):789-92. Unique Identifier : AIDSLINE
MED/94355514
AB The value of monitoring titers of cryptococcal antigen in serum and
cerebrospinal fluid (CSF) during therapy for AIDS-associated
cryptococcal meningitis was evaluated. Baseline and final titers of
antigen in serum and CSF from participants in two studies of such
therapy were categorized as increased (a rise of at least two
dilutions), unchanged, or decreased (a fall of at least two dilutions).
There was no correlation between outcome and changes in serum titers of
cryptococcal antigen during treatment for acute meningitis or during
suppressive therapy. During therapy for acute infection, an unchanged or
increased titer of antigen in CSF was correlated with clinical and
microbiological failure to respond to treatment; the correlation was
especially strong among patients whose baseline titer of antigen was >
or = 1:8 (P = .01). A rise in CSF antigen titer during suppressive
therapy was associated with relapse of cryptococcal meningitis (P <
.001). We conclude that serial monitoring of cryptococcal antigen, as
conducted in these studies, has a limited role in the management of AIDS
patients with cryptococcal meningitis.
DE Acute Disease Amphotericin B/*THERAPEUTIC USE Antigens,
Fungal/*ANALYSIS/BLOOD/CEREBROSPINAL FLUID AIDS-Related Opportunistic
Infections/BLOOD/CEREBROSPINAL FLUID/ DRUG THERAPY/*MICROBIOLOGY
Biological Markers/BLOOD/CEREBROSPINAL FLUID Cryptococcus
neoformans/*IMMUNOLOGY/ISOLATION & PURIF Fluconazole/*THERAPEUTIC USE
Fungemia/MICROBIOLOGY Meningitis, Cryptococcal/BLOOD/CEREBROSPINAL
FLUID/DRUG THERAPY/ *MICROBIOLOGY
Polysaccharides/*ANALYSIS/BLOOD/CEREBROSPINAL FLUID Prognosis Support,
U.S. Gov't, P.H.S. Treatment Outcome CLINICAL TRIAL JOURNAL ARTICLE
MULTICENTER STUDY
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).