Efficacy and safety of amphotericin B in 124 AIDS-associated cryptococcal meningitis patients

Abstract

Abstract:

Objective To observe the efficacy and safety of amphotericin B combined with 5-FC in the treatment of AIDS-associated cryptococcal meningitis. Methods We prospectively enrolled 124 AIDS adults with cryptococcal meningitisand received treatment with amphotericin B + 5FC over 2 weeks, who presented to the public health clinical center of Chengdu from January 2013 to July 2018. Results The mean age of 124 patients was (38.85 + 11.22) years old. Mean course of disease was (22.40 + 17.75) days. The most common clinical symptoms were headache (89.52%), fever (47.58), nausea and vomiting (38.71%).The median CD4⁺T lymphocyte count and plasma HIV RNA of 107 ART-naïve patients were 18 cells/μl and 1.38×10⁵ copies/ml. 62.9% patients had a cerebrospinal fluid pressure higher than 250 mmH₂O. AmB infusion treatment time was (4.97 + 1.13) days, and the average treatment time was (33.42 + 13.53) day. The number of cerebrospinal fluid cells and protein content decreased at 2 weeks after treatment compared with that before treatment, while glucose increased. It showed a significant difference (P<0.05). The negative conversion rate of CSF culture was 87.10% at 2 weeks and 96.77% at 4 weeks.2.42% (3/124) patients discontinued AmB due to severe adverse drug reactions. Mortalities were 4.03% at 4 weeks and 12.90% at 12 weeks. Conclusion A short-term use of AmB combined with 5-FC in the treatment of AIDS-associated cryptococcal meningitis was effective and safety. Blood test, liver function, kidney function and electrolyte should be closely monitored during the treatment.

Key words: AIDS, cryptococcal meningitis, amphotericin B, efficacy

CLC Number:

R519.4

HE Yuan-hong, TAN qing, YANG Tong-tong, HE Sheng-hua, WANG Yin, ZHOU Rui-feng, CAI Lin. Efficacy and safety of amphotericin B in 124 AIDS-associated cryptococcal meningitis patients[J]. Chinese Journal of Mycology, 2019, 14(6): 346-350.

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