Single-Dose Amphotericin B for HIV Patients with Cryptococcal Meningitis?

Single-dose treatment was noninferior to multiple-dose regimens.

Cryptococcal meningitis (CM) accounts for 20% of deaths due to HIV-1 infection in resource-limited settings. Although intravenous amphotericin B deoxycholate (AmB-d) for 14 days is recommended therapy, the toxicity and need for laboratory monitoring and hospitalization have kept the use of this regimen low in low-income regions. Liposomal amphotericin B (L-AmB), which is also recommended for HIV-associated CM, is less toxic than AmB-d, and its long half-life and effective brain penetration suggest that treatment with brief courses at high doses may be therapeutic.

To test this hypothesis, investigators conducted a noninferiority phase II trial in Botswana and Tanzania between 2014 and 2016 involving 80 HIV-infected adults with a first episod…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Single-Dose Amphotericin B for HIV Patients with Cryptococcal Meningitis?

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Reviewing Author