Timing of Antiretroviral Therapy after Diagnosis of Cryptococcal Meningitis

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Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis.

BACKGROUND Cryptococcal meningitis accounts for 20 to 25% of acquired immunodeficiency syndrome-related deaths in Africa. Antiretroviral therapy (ART) is essential for survival; however, the question of when ART should be initiated after diagnosis of cryptococcal meningitis remains unanswered. METHODS We assessed survival at 26 weeks among 177 human immunodeficiency virus-infected adults in U...

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Clinical Outcomes of Cryptococcal Meningitis among Hiv-infected Patients in the Era of Antiretroviral Therapy

Cryptococcal meningitis (CM) is a common opportunistic infection in HIV-infected patients and the clinical outcome can be severe. This study aimed to determine the survival rate and prognostic factors among HIV-infected patients with CM in the era of antiretroviral therapy (ART). Understanding of these facts may help clinicians to manage CM patients efficiently and patients with poor prognostic...

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Timing of antiretroviral therapy in Cambodian hospital after diagnosis of tuberculosis: impact of revised WHO guidelines.

OBJECTIVE To determine if implementation of 2010 World Health Organization (WHO) guidelines on antiretroviral therapy (ART) initiation reduced delay from tuberculosis diagnosis to initiation of ART in a Cambodian urban hospital. METHODS A retrospective cohort study was conducted in a nongovernmental hospital in Phnom Penh that followed new WHO guidelines in patients with human immunodeficienc...

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Combination Antifungal Therapy for Cryptococcal Meningitis

Jeremy N. Day, M.D., Ph.D., Tran T.H. Chau, M.D., Ph.D., Marcel Wolbers, Ph.D., Pham P. Mai, M.D., Nguyen T. Dung, M.D., Nguyen H. Mai, M.D., Ph.D., Nguyen H. Phu, M.D., Ph.D., Ho D. Nghia, M.D., Ph.D., Nguyen D. Phong, M.D., Ph.D., Cao Q. Thai, M.D., Le H. Thai, M.D., Ly V. Chuong, M.D., Dinh X. Sinh, M.D., Van A. Duong, B.Sc., Thu N. Hoang, M.Sc., Pham T. Diep, B.Sc., James I. Campbell, M.I.B...

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Combination antifungal therapy for cryptococcal meningitis.

BACKGROUND Combination antifungal therapy (amphotericin B deoxycholate and flucytosine) is the recommended treatment for cryptococcal meningitis but has not been shown to reduce mortality, as compared with amphotericin B alone. We performed a randomized, controlled trial to determine whether combining flucytosine or high-dose fluconazole with high-dose amphotericin B improved survival at 14 and...

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ژورنال

عنوان ژورنال: New England Journal of Medicine

سال: 2014

ISSN: 0028-4793,1533-4406

DOI: 10.1056/nejmoa1312884