Treatment of non-meningeal cryptococcosis in patients with AIDS. Centre d'Informations et de Soins de l'Immunodéficience Humaine de l'Est Parisien

Amphotericin B, alone or combined with flucytosine, is the reference curative treatment for neuromeningeal cryptococcosis associated with the acquired immune deficiency syndrome (AIDS). Treatment of non-meningeal forms is less well standardized. Out of 75 human immunodeficiency virus (HIV)-infected...

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Bibliographic Details
Published in:The Journal of infection 1996-07, Vol.33 (1), p.7-10
Main Authors: Meyohas, M C, Meynard, J L, Bollens, D, Roux, P, Deluol, A M, Poirot, J L, Rozenbaum, W, Mayaud, C, Frottier, J
Format: Article
Language:English
Subjects:
Adult
AIDS-Related Opportunistic Infections - drug therapy
AIDS/HIV
Amphotericin B - therapeutic use
Antifungal Agents - therapeutic use
Cryptococcosis - drug therapy
Female
Fluconazole - therapeutic use
Follow-Up Studies
Humans
Male
Middle Aged
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Summary:Amphotericin B, alone or combined with flucytosine, is the reference curative treatment for neuromeningeal cryptococcosis associated with the acquired immune deficiency syndrome (AIDS). Treatment of non-meningeal forms is less well standardized. Out of 75 human immunodeficiency virus (HIV)-infected patients with cryptococcosis, 16 had no meningeal involvement. One died before receiving any treatment, another received amphotericine B and recovered, and the remaining 14 received curative therapy with fluconazole (200-400 mg/day); 11 of the latter entered complete remission, while three deteriorated during the first week of treatment but recovered on amphotericin B combined, in two cases, with fluconazole. Only one relapse occurred during maintenance treatment with low-dose fluconazole (100 mg/day). No adverse effects of fluconazole treatment were observed. One of the patients on amphotericin B developed acute renal impairment requiring drug withdrawal. These results suggest that first-line fluconazole therapy is effective and well tolerated in patients with AIDS-associated non meningeal cryptococcosis.
ISSN:0163-4453