Document 0966
 DOCN  M94A0966
 TI    High mortality in AIDS patients with cryptococcal meningitis despite
       fluconazole therapy in Uganda.
 DT    9412
 AU    Oishi K; Mugerwa R; Mitarai S; Mayanja H; Nalongo K; Nagatake T;
       Matsumoto K; Dept of Intern Med, Nagasaki Univ. Japan.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):24 (abstract no. 387B). Unique
       Identifier : AIDSLINE ICA10/94371609
 AB    INTRODUCTION: Cryptococcal meningitis (CM) is a particularly common and
       fatal opportunistic infection, occurring to 30% of AIDS patients in
       Africa. OBJECTIVE: To demonstrate the clinical features of CM in AIDS
       patients, and to establish the effective antifungal chemotherapy for
       this disease in Africa. METHODS: 40 HIV-seropositive patients who were
       positive for India ink staining and cryptococcal antigen test in CSF
       were enrolled. These patients were treated with oral fluconazole (FCZ)
       at doses of 200mg or 400mg for 2 months at random. CD4 levels and CD4/8
       ratios in peripheral blood from 13 patients were determined using
       Dyna-beads T4-T8 Quant Kit (Dynal). RESULTS: The mean age and the ratio
       of male/female in these patients were 31.0 years and 2.0, respectively.
       Patients had headache (100%), prolonged fever (80%), oral candidiasis
       (70%), and abnormalities in consciousness (38%). The mean (+SD) of CD4
       levels and CD4/8 ratios were 97 + 81/mm3 and 0.35 + 0.23, respectively.
       50% of patients died within two weeks after initial therapy. Similar
       clinical response rates (33%) were observed in patients who received FCZ
       at doses of 200 mg or 400mg at 2 months post-therapy. DISCUSSION AND
       CONCLUSION: Frequency of abnormalities in consciousness before therapy
       were relatively high, and severe immunosuppression was observed. Early
       diagnosis and intensive therapy were strongly desired for patients with
       CM. Treatment of CM with another anti-fungal regimen with FCZ at a dose
       of 200mg and flucytosine (150mg/kg) for CM is under developing.
 DE    AIDS-Related Opportunistic Infections  Female  Fluconazole/*THERAPEUTIC
       USE  Human  Leukocyte Count  Male  Meningitis, Cryptococcal/BLOOD/DRUG
       THERAPY/*MORTALITY  Survival Rate  T4 Lymphocytes  Uganda/EPIDEMIOLOGY
       MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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