Short-Course Induction Treatment with Intrathecal Amphotericin B Lipid Emulsion for HIV Infected Patients with Cryptococcal Meningitis
Joint Authors
Alvarez-Uria, Gerardo
Reddy, Raghuprakash
Midde, Manoranjan
Yalla, Pradeep S.
Pakam, Raghavakalyan
Naik, Praveen K.
Source
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-09-10
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Cryptococcal meningitis (CM) is a common cause of death among HIV infected patients in developing countries, especially in sub-Saharan Africa.
In this observational HIV cohort study in a resource-limited setting in India, we compared the standard two-week intravenous amphotericin B deoxycholate (AmBd) (Regimen I) with one week of intravenous AmBd along with daily therapeutic lumbar punctures and intrathecal AmB lipid emulsion (Regimen II) during the intensive phase of CM treatment.
78 patients received Regimen I and 45 patients received Regimen II.
After adjustment for baseline characteristics (gender, age, altered mental status or seizures at presentation, CD4 cell count, white blood cells, cerebrospinal fluid white cells, and haemoglobin), the use of Regimen II was associated with a significant relative risk reduction in mortality (adjusted hazard ratio 0.4, 95% confidence interval, 0.22–0.76) and 26.7% absolute risk reduction (95% confidence interval, 9.9–43.5) at 12 weeks.
The use of Regimen II resulted in lower costs of drugs and hospital admission days.
Since the study is observational in nature, we should be cautious about our results.
However, the good tolerability of intrathecal administration of AmB lipid emulsion and the clinically important mortality reduction observed with the short-course induction treatment warrant further research, ideally through a randomized clinical trial.
American Psychological Association (APA)
Alvarez-Uria, Gerardo& Midde, Manoranjan& Pakam, Raghavakalyan& Yalla, Pradeep S.& Naik, Praveen K.& Reddy, Raghuprakash. 2015. Short-Course Induction Treatment with Intrathecal Amphotericin B Lipid Emulsion for HIV Infected Patients with Cryptococcal Meningitis. Journal of Tropical Medicine،Vol. 2015, no. 2015, pp.1-6.
https://search.emarefa.net/detail/BIM-1070416
Modern Language Association (MLA)
Alvarez-Uria, Gerardo…[et al.]. Short-Course Induction Treatment with Intrathecal Amphotericin B Lipid Emulsion for HIV Infected Patients with Cryptococcal Meningitis. Journal of Tropical Medicine No. 2015 (2015), pp.1-6.
https://search.emarefa.net/detail/BIM-1070416
American Medical Association (AMA)
Alvarez-Uria, Gerardo& Midde, Manoranjan& Pakam, Raghavakalyan& Yalla, Pradeep S.& Naik, Praveen K.& Reddy, Raghuprakash. Short-Course Induction Treatment with Intrathecal Amphotericin B Lipid Emulsion for HIV Infected Patients with Cryptococcal Meningitis. Journal of Tropical Medicine. 2015. Vol. 2015, no. 2015, pp.1-6.
https://search.emarefa.net/detail/BIM-1070416
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1070416