Inadequacy of High-Dose Fluconazole Monotherapy among Cerebrospinal Fluid Cryptococcal Antigen (CrAg)-Positive Human Immunodeficiency Virus-Infected Persons in an Ethiopian CrAg Screening Program

Tafese Beyene, Anteneh G. Zewde, Abera Balcha, Belda Hirpo, Tadele Yitbarik, Teshome Gebissa, Radha Rajasingham, David R. Boulware

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

A total of 817 human immunodeficiency virus-infected Ethiopians with CD4 <150 cells/mL underwent plasma cryptococcal antigen (CRAG) screening. CRAG prevalence was 6.2%. Of participants with plasma CRAG titers >1:640, 96% (27 of 28) had cryptococcal meningitis (cerebrospinal fluid CRAGpositive) whereas 50% (7 of 14) with 1:160-1:320 titers had meningitis. With fluconazole 1200 mg/d therapy, 68% of meningitis patients (23 of 34) died within 3 months. Plasma CRAG titers >1:160 predict meningitis, requiring more intensive antifungal therapy.

Original languageEnglish (US)
Pages (from-to)2126-2129
Number of pages4
JournalClinical Infectious Diseases
Volume65
Issue number12
DOIs
StatePublished - Dec 15 2017

Keywords

  • Cryptococcal meningitis /PC
  • Cryptococcosis /PC
  • Cryptococcus
  • Ethiopia
  • Fluconazole
  • Mass Screening
  • Prevention & Control

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