Document 0329
 DOCN  M94A0329
 TI    Measurement of cryptococcal antigen in serum and cerebrospinal fluid:
       value in the management of AIDS-associated cryptococcal meningitis.
 DT    9412
 AU    Powderly WG; Cloud GA; Dismukes WE; Saag MS; Division of Infectious
       Diseases, Washington University School of; Medicine, St. Louis, Missouri
       63110.
 SO    Clin Infect Dis. 1994 May;18(5):789-92. Unique Identifier : AIDSLINE
       MED/94355514
 AB    The value of monitoring titers of cryptococcal antigen in serum and
       cerebrospinal fluid (CSF) during therapy for AIDS-associated
       cryptococcal meningitis was evaluated. Baseline and final titers of
       antigen in serum and CSF from participants in two studies of such
       therapy were categorized as increased (a rise of at least two
       dilutions), unchanged, or decreased (a fall of at least two dilutions).
       There was no correlation between outcome and changes in serum titers of
       cryptococcal antigen during treatment for acute meningitis or during
       suppressive therapy. During therapy for acute infection, an unchanged or
       increased titer of antigen in CSF was correlated with clinical and
       microbiological failure to respond to treatment; the correlation was
       especially strong among patients whose baseline titer of antigen was >
       or = 1:8 (P = .01). A rise in CSF antigen titer during suppressive
       therapy was associated with relapse of cryptococcal meningitis (P <
       .001). We conclude that serial monitoring of cryptococcal antigen, as
       conducted in these studies, has a limited role in the management of AIDS
       patients with cryptococcal meningitis.
 DE    Acute Disease  Amphotericin B/*THERAPEUTIC USE  Antigens,
       Fungal/*ANALYSIS/BLOOD/CEREBROSPINAL FLUID  AIDS-Related Opportunistic
       Infections/BLOOD/CEREBROSPINAL FLUID/  DRUG THERAPY/*MICROBIOLOGY
       Biological Markers/BLOOD/CEREBROSPINAL FLUID  Cryptococcus
       neoformans/*IMMUNOLOGY/ISOLATION & PURIF  Fluconazole/*THERAPEUTIC USE
       Fungemia/MICROBIOLOGY  Meningitis, Cryptococcal/BLOOD/CEREBROSPINAL
       FLUID/DRUG THERAPY/  *MICROBIOLOGY
       Polysaccharides/*ANALYSIS/BLOOD/CEREBROSPINAL FLUID  Prognosis  Support,
       U.S. Gov't, P.H.S.  Treatment Outcome  CLINICAL TRIAL  JOURNAL ARTICLE
       MULTICENTER STUDY

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