A pragmatic approach to managing antiretroviral therapy-experienced patients diagnosed with HIV-associated cryptococcal meningitis: impact of antiretroviral therapy adherence and duration

Melanie Alufandika^{1

2}, David S Lawrence^{3

4}, Timothée Boyer-Chammard^{5

6}, Cecilia Kanyama⁷, Chiratidzo E Ndhlovu⁸, Mosepele Mosepele^{4

9}, Lillian Tugume¹⁰, David Meya^{10

11}, David R Boulware¹¹, Joshua Rhein^{10

11}, Conrad Muzoora¹², Nabila Youssouf^{3

4}, Síle F Molloy^{13

14}, Charlotte Schutz^{14

15}, Olivier Lortholary^{5

6}, Graeme Meintjes^{14

15}, Henry C Mwandumba^{1

16}, Thomas S Harrison¹³, Joseph N Jarvis^{3

4}; and the AMBITION-cm Study Group

Affiliations

¹ Malawi-Liverpool-Wellcome Trust Clinical Research Programme.
² African Centre of Excellence in Public Health and Herbal medicine (ACEPHEM), University of Malawi College of Medicine, Blantyre, Malawi.
³ Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
⁴ Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
⁵ Molecular Mycology Unit and National Reference Centre for Invasive Mycoses, UMR2000, CNRS, Institut Pasteur.
⁶ Necker Pasteur Center for Infectious Diseases and Tropical Medicine, Hôpital Necker Enfants malades, AP-HP, IHU Imagine, Université de Paris, Paris, France.
⁷ Lilongwe Medical Relief Trust (UNC Project), Lilongwe, Malawi.
⁸ Department of Medicine, University of Zimbabwe College of Health Sciences, Parirenyatwa Hospital, Harare, Zimbabwe.
⁹ Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
¹⁰ Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
¹¹ University of Minnesota, Minneapolis, USA.
¹² Mbarara University of Science and Technology, Mbarara, Uganda.
¹³ Centre for Global Health, Institute of Infection and Immunity, St George's University of London, London, UK.
¹⁴ Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine.
¹⁵ Department of Medicine, University of Cape Town, Cape Town, South Africa.
¹⁶ Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.

PMID: 32590438
PMCID: PMC7473821
DOI: 10.1097/QAD.0000000000002556

A pragmatic approach to managing antiretroviral therapy-experienced patients diagnosed with HIV-associated cryptococcal meningitis: impact of antiretroviral therapy adherence and duration

Melanie Alufandika et al. AIDS. 2020.

. 2020 Jul 15;34(9):1425-1428.

doi: 10.1097/QAD.0000000000002556.

Authors

Affiliations

¹ Malawi-Liverpool-Wellcome Trust Clinical Research Programme.
² African Centre of Excellence in Public Health and Herbal medicine (ACEPHEM), University of Malawi College of Medicine, Blantyre, Malawi.
³ Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
⁴ Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
⁵ Molecular Mycology Unit and National Reference Centre for Invasive Mycoses, UMR2000, CNRS, Institut Pasteur.
⁶ Necker Pasteur Center for Infectious Diseases and Tropical Medicine, Hôpital Necker Enfants malades, AP-HP, IHU Imagine, Université de Paris, Paris, France.
⁷ Lilongwe Medical Relief Trust (UNC Project), Lilongwe, Malawi.
⁸ Department of Medicine, University of Zimbabwe College of Health Sciences, Parirenyatwa Hospital, Harare, Zimbabwe.
⁹ Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
¹⁰ Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
¹¹ University of Minnesota, Minneapolis, USA.
¹² Mbarara University of Science and Technology, Mbarara, Uganda.
¹³ Centre for Global Health, Institute of Infection and Immunity, St George's University of London, London, UK.
¹⁴ Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine.
¹⁵ Department of Medicine, University of Cape Town, Cape Town, South Africa.
¹⁶ Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.

PMID: 32590438
PMCID: PMC7473821
DOI: 10.1097/QAD.0000000000002556

No abstract available

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Conflict of interest statement

There are no conflicts of interest.

Figures

**Fig. 1**
Suggested management of antiretroviral therapy-experienced participants diagnosed with cryptococcal meningitis.

See this image and copyright information in PMC

References

1. Rajasingham R, Smith RM, Park BJ, Jarvis JN, Govender NP, Chiller TM, et al. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. Lancet Infect Dis 2017; 17:873–881. - PMC - PubMed
1. Tenforde MW, Mokomane M, Leeme T, Patel RKK, Lekwape N, Ramodimoosi C, et al. Advanced human immunodeficiency virus disease in Botswana following successful antiretroviral therapy rollout: Incidence of and temporal trends in cryptococcal meningitis. Clin Infect Dis 2017; 65:779–786. - PMC - PubMed
1. Osler M, Hilderbrand K, Goemaere E, Ford N, Smith M, Meintjes G, et al. The continuing burden of advanced HIV disease over 10 years of increasing antiretroviral therapy coverage in South Africa. Clin Infect Dis 2018; 66:S118–S125. - PMC - PubMed
1. Mpoza E, Rajasingham R, Tugume L, Rhein J, Nabaggala MS, Ssewanyana I, et al. Cryptococcal antigenemia in human immunodeficiency virus antiretroviral therapy–experienced Ugandans with virologic failure. Clin Infect Dis 2019; [Epub ahead of print]. - PMC - PubMed
1. Molloy SF, Kanyama C, Heyderman RS, Loyse A, Kouanfack C, Chanda D, et al. ACTA Trial Study Team. Antifungal combinations for treatment of cryptococcal meningitis in Africa. N Engl J Med 2018; 378:1004–1017. - PubMed

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A pragmatic approach to managing antiretroviral therapy-experienced patients diagnosed with HIV-associated cryptococcal meningitis: impact of antiretroviral therapy adherence and duration

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A pragmatic approach to managing antiretroviral therapy-experienced patients diagnosed with HIV-associated cryptococcal meningitis: impact of antiretroviral therapy adherence and duration

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Conflict of interest statement

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