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Expert Rev Anti Infect Ther. 2017 Apr;15(4):331-340. doi: 10.1080/14787210.2017.1285697. Epub 2017 Feb 9.

Recent advances in AIDS-related cryptococcal meningitis treatment with an emphasis on resource limited settings.

Author information

1
a Division of Infectious Diseases & International Medicine, Department of Medicine , University of Minnesota , Minneapolis , MN , USA.
2
b Infectious Disease Institute, Makerere University , Kampala , Uganda.

Abstract

Recent advances in the treatment and prevention of cryptococcal meningitis have the potential to decrease AIDS-related deaths. Areas covered: Targeted screening for asymptomatic cryptococcal antigenemia in persons with AIDS is a cost effective method for reducing early mortality in patients on antiretroviral therapy. For persons with symptomatic cryptococcal meningitis, optimal initial management with amphotericin and flucytosine improves survival compared to alternative therapies; however, amphotsericin is difficult to administer and flucytosine has not been available in middle or low income countries, where cryptococcal meningitis is most prevalent. Expert commentary: Improved care for cryptococcal meningitis patients in resource-limited settings is possible, and new treatment possibilities are emerging.

KEYWORDS:

AIDS; CM-IRIS; HIV; antifungal therapy; antiretroviral therapy; cryptococcal meningitis; immune reconstitution inflammatory syndrome; review; sertraline

PMID:
28111998
PMCID:
PMC5602588
DOI:
10.1080/14787210.2017.1285697
[Indexed for MEDLINE]
Free PMC Article

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