Waters Laura, Nelson Mark
St Stephen's Centre, Chelsea & Westminster Hospital, London, UK.
Expert Opin Investig Drugs. 2007 Jun;16(6):899-908. doi: 10.1517/13543784.16.6.899.
Fungal infections are a significant cause of HIV-related morbidity and mortality, particularly in the developing world, but also in countries with access to highly active antiretroviral therapy. New agents are essential to improve present efficacy rates, particularly in cases of drug resistance. Caspofungin is a new antifungal from the echinocandin class and is licensed for the treatment of candidal infections and as a second-line therapy for invasive aspergillosis. In this paper, the pharmacology, interaction and susceptibility data for this agent are reviewed and studies supporting the use of this agent in HIV-infected individuals are examined. Finally, evidence for the use of caspofungin for the treatment of Pneumocystis jiroveci pneumonia, an unlicensed indication, including a case series from our own unit is explored.
真菌感染是导致HIV相关发病和死亡的一个重要原因，在发展中国家尤为如此，在那些可获得高效抗逆转录病毒治疗的国家也是如此。新型药物对于提高目前的治愈率至关重要，尤其是在耐药病例中。卡泊芬净是棘白菌素类的一种新型抗真菌药物，已获许可用于治疗念珠菌感染，并作为侵袭性曲霉病的二线治疗药物。本文回顾了该药物的药理学、相互作用及药敏数据，并审视了支持在HIV感染者中使用该药物的研究。最后，探讨了使用卡泊芬净治疗耶氏肺孢子菌肺炎（一种未获许可的适应证）的证据，包括来自我们科室的一个病例系列。
