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1 July 2007

Volume 45, Number 1
Clinical Infectious Diseases 2007;45:76–80
© 2007 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2007/4501-0014$15.00
DOI: 10.1086/518607
BRIEF REPORT

Fungal Burden, Early Fungicidal Activity, and Outcome in Cryptococcal Meningitis in Antiretroviral‐Naive or Antiretroviral‐Experienced Patients Treated with Amphotericin B or Fluconazole

Tihana Bicanic,1,4

Graeme Meintjes,2,3

Robin Wood,1

Madeleine Hayes,4

Kevin Rebe,2,3

Linda‐Gail Bekker,1 and

Thomas Harrison1,4

1Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, and 2Department of Medicine, University of Cape Town, and 3HIV Service, GF Jooste Hospital, Cape Town, South Africa; and 4Division of Infectious Diseases, Department of Cellular and Molecular Medicine, St. George’s University of London, London, United Kingdom

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.

Received 8 December 2006; accepted 21 February 2007; electronically published 25 May 2007.

  • (See the editorial commentary by Lortholary on pages 81–3)

Reprints or correspondence: Dr. Tihana Bicanic, Div. of Infectious Diseases, Dept. of Cellular and Molecular Medicine, St. George’s University of London, Cranmer Terrace, London SW17 ORE, United Kingdom ().

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Joseph N Jarvis, Andrew Boulle, Angela Loyse, Tihana Bicanic, Kevin Rebe, Anthony Williams, Thomas S Harrison, Graeme Meintjes. (2009) High ongoing burden of cryptococcal disease in Africa despite antiretroviral roll out. AIDS 23:9, 1182-1183
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Joseph N. Jarvis, Stephen D. Lawn, Monica Vogt, Nonzwakazi Bangani, Robin Wood, and Thomas S. Harrison. (2009) Screening for Cryptococcal Antigenemia in Patients Accessing an Antiretroviral Treatment Program in South Africa. Clinical Infectious Diseases 48:7, 856-862
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Thomas S Harrison. (2009) The burden of HIV-associated cryptococcal disease. AIDS 23:4, 531-532
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Joseph N Jarvis, Francoise Dromer, Thomas S Harrison, Olivier Lortholary. (2009) Managing cryptococcosis in the immunocompromised host. Current Opinion in Infectious Diseases 21:6, 596-603
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Olivier Lortholary. (2007) Editorial Commentary: Management of Cryptococcal Meningitis in AIDS: The Need for Specific Studies in Developing Countries. Clinical Infectious Diseases 45:1, 81-83
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  • Presented in part: 46th Interscience Conference of Antimicrobial Agents and Chemotherapy, San Francisco, October 2006 (abstract 1768).

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