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

Tafese Beyene | Zendy; Anteneh Zewde | Zendy; Abera Balcha | Zendy; Belda Hirpo | Zendy; Tadele Yitbarik | Zendy; Teshome Gebissa | Zendy; Radha Rajasingham | Zendy; David R. Boulware | Zendy

Open Access

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

Author(s) -

Tafese Beyene,

Anteneh Zewde,

Abera Balcha,

Belda Hirpo,

Tadele Yitbarik,

Teshome Gebissa,

Radha Rajasingham,

David R. Boulware

Publication year - 2017

Publication title -

clinical infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.44

H-Index - 336

eISSN - 1537-6591

pISSN - 1058-4838

DOI - 10.1093/cid/cix613

Subject(s) - medicine , fluconazole , cerebrospinal fluid , human immunodeficiency virus (hiv) , virology , sida , antigen , immunology , aids related opportunistic infections , viral disease , antifungal , dermatology

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 CRAG-positive) 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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