Document 0752
 DOCN  M9490752
 TI    The role of azoles in the treatment and prophylaxis of cryptococcal
       disease in HIV infection.
 DT    9411
 AU    Nelson MR; Fisher M; Cartledge J; Rogers T; Gazzard BG; HIV/GUM unit,
       Chelsea & Westminster Hospital, London, UK.
 SO    AIDS. 1994 May;8(5):651-4. Unique Identifier : AIDSLINE MED/94338601
 AB    OBJECTIVE: To assess the role of azole therapy in the treatment and
       prophylaxis of cryptococcosis in HIV-seropositive individuals. STUDY
       DESIGN: Retrospective case review. SETTING: A dedicated HIV unit in
       London, UK. PATIENTS: Fifty individuals with a positive cryptococcal
       antigen or culture from any site between 1 January 1985 and 31 December
       1992. RESULTS: Thirty-eight patients initially presented with meningitis
       and 12 with alternative disease, five of whom subsequently developed
       meningeal disease. The 12 patients who presented without meningitis
       received chronic suppressive therapy after the diagnosis of cryptococcal
       disease. Two patients receiving itraconazole developed meningitis as did
       three out of four treated with 200 mg fluconazole daily, but none of the
       six receiving 400 mg fluconazole daily. Treatment of cryptococcal
       meningitis was successful in 17 of the 19 patients given fluconazole but
       only three of the six receiving itraconazole. Following successful
       treatment of meningitis five out of seven patients given itraconazole
       and five out of seven given 200 mg fluconazole daily relapsed compared
       with three out of 25 receiving 400 mg fluconazole daily. CONCLUSION:
       Fluconazole is an effective treatment for cryptococcal meningitis. For
       prophylaxis following meningitis, a dose of 400 mg fluconazole is the
       preferred treatment; lower doses are associated with a higher relapse
       rate.
 DE    Amphotericin B/THERAPEUTIC USE  AIDS-Related Opportunistic
       Infections/*DRUG THERAPY/MORTALITY/  PREVENTION & CONTROL
       Cryptococcosis/*DRUG THERAPY/MORTALITY/PREVENTION & CONTROL
       Fluconazole/*THERAPEUTIC USE  Fungemia/DRUG THERAPY/MORTALITY  Human
       Itraconazole/*THERAPEUTIC USE  London/EPIDEMIOLOGY  Meningitis,
       Cryptococcal/DRUG THERAPY/MORTALITY/PREVENTION &  CONTROL  Recurrence
       Retrospective Studies  Survival Analysis  JOURNAL ARTICLE  REVIEW
       REVIEW, MULTICASE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).