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

doi:10.1093/cid/cix613

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 journal › Article › peer-review

57 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 language	English (US)
Pages (from-to)	2126-2129
Number of pages	4
Journal	Clinical Infectious Diseases
Volume	65
Issue number	12
DOIs	https://doi.org/10.1093/cid/cix613
State	Published - Dec 15 2017

Bibliographical note

Funding Information:
Financial support. This work is supported by the National Center for Advancing Translational Sciences, National Institutes of Health (grant UL1TR000114 to R. R. and R01AI118511 to D. R. B., R. R.).

Publisher Copyright:
© 2017 The Author. Published by Oxford University Press for the Infectious Diseases Society of America.

Keywords

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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.1093/cid/cix613

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850618

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Beyene, T., Zewde, A. G., Balcha, A., Hirpo, B., Yitbarik, T., Gebissa, T., Rajasingham, R., & Boulware, D. R. (2017). Inadequacy of High-Dose Fluconazole Monotherapy among Cerebrospinal Fluid Cryptococcal Antigen (CrAg)-Positive Human Immunodeficiency Virus-Infected Persons in an Ethiopian CrAg Screening Program. Clinical Infectious Diseases, 65(12), 2126-2129. https://doi.org/10.1093/cid/cix613

Inadequacy of High-Dose Fluconazole Monotherapy among Cerebrospinal Fluid Cryptococcal Antigen (CrAg)-Positive Human Immunodeficiency Virus-Infected Persons in an Ethiopian CrAg Screening Program. / Beyene, Tafese; Zewde, Anteneh G.; Balcha, Abera et al.
In: Clinical Infectious Diseases, Vol. 65, No. 12, 15.12.2017, p. 2126-2129.

Research output: Contribution to journal › Article › peer-review

Beyene, T, Zewde, AG, Balcha, A, Hirpo, B, Yitbarik, T, Gebissa, T, Rajasingham, R & Boulware, DR 2017, 'Inadequacy of High-Dose Fluconazole Monotherapy among Cerebrospinal Fluid Cryptococcal Antigen (CrAg)-Positive Human Immunodeficiency Virus-Infected Persons in an Ethiopian CrAg Screening Program', Clinical Infectious Diseases, vol. 65, no. 12, pp. 2126-2129. https://doi.org/10.1093/cid/cix613

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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.",

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

Abstract

Bibliographical note

Keywords

UN SDGs

Publisher link

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