Treatment of cryptococcosis with liposomal amphotericin B (AmBisome) in 23 patients with AIDS

Abstract

Objective: To determine the safety and efficacy of liposomal amphotericin B (AmBisome) in the primary treatment of AIDS-associated cryptococcosis.

Design: A Phase II, multicentre, European, non-comparative, open study to assess the use of AmBisome in 23 patients (26 enrolments) with cryptococcosis. Dose requirements, mycological response and toxicity were documented.

Setting: Hospital-based HIV units.

Patients: Twenty-three HIV-1-seropositive patients.

Results: Drug toxicity, assessed in 25 enrolments, was well-tolerated with little renal, hepatic or haematological toxicity. Eighteen out of 23 (78%) enrolments responded clinically. Nineteen enrolments had cryptococcal meningitis: sterilization of spinal fluid was achieved in 12 out of the 18 (67%) who were mycologically evaluable. Fourteen out of the 19 (74%) responded clinically.

Conclusion: AmBisome is well-tolerated and may be an effective formulation in the treatment of cryptococcosis.