艾滋病相关隐球菌性脑膜炎治疗的最新进展，重点关注资源有限的环境。
Recent advances in AIDS-related cryptococcal meningitis treatment with an emphasis on resource limited settings.
作者信息
Lofgren Sarah, Abassi Mahsa, Rhein Joshua, Boulware David R
机构信息
a Division of Infectious Diseases & International Medicine, Department of Medicine , University of Minnesota , Minneapolis , MN , USA.
b Infectious Disease Institute, Makerere University , Kampala , Uganda.
出版信息
Expert Rev Anti Infect Ther. 2017 Apr;15(4):331-340. doi: 10.1080/14787210.2017.1285697. Epub 2017 Feb 9.
Abstract
Recent advances in the treatment and prevention of cryptococcal meningitis have the potential to decrease AIDS-related deaths. Areas covered: Targeted screening for asymptomatic cryptococcal antigenemia in persons with AIDS is a cost effective method for reducing early mortality in patients on antiretroviral therapy. For persons with symptomatic cryptococcal meningitis, optimal initial management with amphotericin and flucytosine improves survival compared to alternative therapies; however, amphotsericin is difficult to administer and flucytosine has not been available in middle or low income countries, where cryptococcal meningitis is most prevalent. Expert commentary: Improved care for cryptococcal meningitis patients in resource-limited settings is possible, and new treatment possibilities are emerging.
摘要
隐球菌性脑膜炎治疗与预防方面的最新进展有可能降低与艾滋病相关的死亡人数。涵盖领域：对艾滋病患者进行无症状隐球菌抗原血症的靶向筛查是降低接受抗逆转录病毒治疗患者早期死亡率的一种具有成本效益的方法。对于有症状的隐球菌性脑膜炎患者，与其他替代疗法相比，两性霉素和氟胞嘧啶的最佳初始治疗可提高生存率；然而，两性霉素难以给药，且氟胞嘧啶在中低收入国家无法获得，而这些国家正是隐球菌性脑膜炎最为普遍的地方。专家评论：在资源有限的环境中改善对隐球菌性脑膜炎患者的护理是可行的，并且新的治疗可能性正在出现。
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