British <scp>HIV</scp> Association opportunistic infection guidelines: in defence of amphotericin <scp>B</scp> deoxycholate

Bicanic, Tihana; Ogden, David; Whitney, Laura; Loyse, Angela; Jarvis, Joseph N

doi:10.1111/j.1468-1293.2012.01022.x

Cited by 8 publications

(3 citation statements)

References 12 publications

(12 reference statements)

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“…A solution in HICs is the use of lipid drug formulations with fewer renal side effects, including liposomal AmB (LAmB; 3–6 mg/kg/day) and AmB lipid complex (ABLC, 5 mg/kg/day) 105–107. The cost of these (over US$1,000 per day108) is prohibitive for MLICs, so alternative strategies, including preemptive hydration and electrolyte supplementation, have been developed to minimize the toxicity of AmBd 99. Studies in Kampala,62 Cape Town,65 and Bangkok109 support this approach.…”

Section: Treatment and Prognosismentioning

confidence: 99%

Cryptococcal meningitis: epidemiology and therapeutic options

Sloan¹,

Parris²

2014

CLEP

226

183

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Cryptococcal meningitis causes morbidity and mortality worldwide. The burden of disease is greatest in middle- and low-income countries with a high incidence of human immunodeficiency virus (HIV) infection. Patients taking immunosuppressive drugs and some immunocompetent hosts are also at risk. Treatment of cryptococcal meningitis consists of three phases: induction, consolidation, and maintenance. Effective induction therapy requires potent fungicidal drugs (amphotericin B and flucytosine), which are often unavailable in low-resource, high-endemicity settings. As a consequence, mortality is unacceptably high. Wider access to effective treatment is urgently required to improve outcomes. For human immunodeficiency virus-infected patients, judicious management of asymptomatic cryptococcal antigenemia and appropriately timed introduction of antiretroviral therapy are important.

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Section: Treatment and Prognosismentioning

confidence: 99%

Cryptococcal meningitis: epidemiology and therapeutic options

Sloan¹,

Parris²

2014

CLEP

226

183

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“…Recently the expert committee panel of the British HIV Association recommended the use of L-AMB (4 mg/kg/d) as preferred amphotericin B preparation for the induction therapy of AIDS-associated CM [217]. On the basis of economic considerations, other UK experts argued strongly against this endorsement [218]. Finally, two new questions, that will be discussed in the next session, emerged as the consequence of the implementation of very efficacious antiretroviral therapy in the HIV setting: (1) the appropriate time of starting ARV (antiretroviral) therapy after the diagnosis of CM; (2) the time and threshold of CD4+ lymphocytes at which maintenance therapy can be safely discontinued.…”

Section: Antifungal Treatmentmentioning

confidence: 99%

New Insights into HIV/AIDS-Associated Cryptococcosis

Antinori

2013

ISRN AIDS

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Cryptococcal meningitis is a life-threatening opportunistic fungal infection in both HIV-infected and HIV-uninfected patients. According to the most recent taxonomy, the responsible fungus is classified into a complex that contains two species (Cryptococcus neoformans and C. gattii), with eight major molecular types. HIV infection is recognized worldwide as the main underlying disease responsible for the development of cryptococcal meningitis (accounting for 80–90% of cases). In several areas of sub-Saharan Africa with the highest HIV prevalence despite the recent expansion of antiretroviral (ARV) therapy programme, cryptococcal meningitis is the leading cause of community-acquired meningitis with a high mortality burden. Although cryptococcal meningitis should be considered a neglected disease, a large body of knowledge has been developed by several studies performed in recent years. This paper will focus especially on new clinical aspects such as immune reconstitution inflammatory syndrome, advances on management, and strategies for the prevention of clinical disease.

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“…Nevertheless, for various reasons, the conventional formulation of AmB with DOC also remains in general use (3,6,7). Specifically, higher effectiveness and/or economic advantages of AmB-DOC in comparison with the more recently introduced lipid preparations have been found in some patient groups (8,9).…”

mentioning

confidence: 99%