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. 2015 Feb;9(2):OC14-6.
doi: 10.7860/JCDR/2015/12360.5601. Epub 2015 Feb 1.

Combination Versus Monotherapy for the Treatment of HIV Associated Cryptococcal Meningitis

Shashank Anant Vaidhya  1 , Bharat Bhushan Gupta  1 , Rajesh Kumar Jha  2 , Ravindra Kumar  3
Affiliations

Combination Versus Monotherapy for the Treatment of HIV Associated Cryptococcal Meningitis

Shashank Anant Vaidhya et al. J Clin Diagn Res. 2015 Feb.

Abstract

Objective: To study the efficacy of anti Cryptococcal treatment by cerebrospinal fluid (CSF) fungal negativity after two weeks of treatment with amphotericin B alone or combined with fluconazole in treatment of HIV associated Cryptococcal meningitis (CM).

Materials and methods: A total of 84 human immunodeficiency virus (HIV) associated CM patients confirmed by CSF culture positivity were recruited for the study. Patients were randomly divided into two groups. Group A was given amphotericin B alone whereas Amphotericin B in combination with fluconazole was given in group B for the treatment of CM. Patients were followed for 14 days.

Results: Maximum number of patients was in the age group 21-49 y. All the 84 patients had <100 CD4 counts/μl. After 14 days of the treatment in group A and B, there was no significant difference in terms of fever, headache and neck stiffness as a clinical outcome. But in group B there was improved in altered sensorium and focal neurological deficit as compared to group A. After 14 days of the treatment CSF culture negativity was more in group B as compared to group A.

Conclusion: Amphotericin B in combination with fluconazole is recommended for the treatment of HIV associated CM.

Keywords: Amphotericin B; Combination therapy; Cryptococcal Meningitis; Fluconazole; HIV.

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