在埃塞俄比亚的隐球菌抗原（CrAg）筛查项目中，高剂量氟康唑单药治疗对脑脊液 CrAg 阳性的人类免疫缺陷病毒感染者无效。
Inadequacy of High-Dose Fluconazole Monotherapy Among Cerebrospinal Fluid Cryptococcal Antigen (CrAg)-Positive Human Immunodeficiency Virus-Infected Persons in an Ethiopian CrAg Screening Program.
机构信息
Asella Teaching Hospital, College of Health Sciences, Arsi University.
Hirsch-Institute of Tropical Medicine Research Centre, Asella, Ethiopia.
出版信息
Clin Infect Dis. 2017 Nov 29;65(12):2126-2129. doi: 10.1093/cid/cix613.
Abstract
A total of 817 human immunodeficiency virus-infected Ethiopians with CD4 <150 cells/mL underwent plasma cryptococcal antigen (CRAG) screening. CRAG prevalence was 6.2%. Of participants with plasma CRAG titers >1:640, 96% (27 of 28) had cryptococcal meningitis (cerebrospinal fluid CRAG-positive) whereas 50% (7 of 14) with 1:160-1:320 titers had meningitis. With fluconazole 1200 mg/d therapy, 68% of meningitis patients (23 of 34) died within 3 months. Plasma CRAG titers >1:160 predict meningitis, requiring more intensive antifungal therapy.
摘要
共有 817 名 CD4 细胞<150 个/毫升的艾滋病毒感染者接受了血浆隐球菌抗原（CRAG）筛查。CRAG 的患病率为 6.2%。在血浆 CRAG 滴度>1:640 的参与者中，96%（27/28）患有隐球菌性脑膜炎（脑脊液 CRAG 阳性），而滴度为 1:160-1:320 的参与者中有 50%（7/14）患有脑膜炎。在氟康唑 1200mg/d 治疗中，68%（23/34）的脑膜炎患者在 3 个月内死亡。血浆 CRAG 滴度>1:160 预测脑膜炎，需要更强化的抗真菌治疗。
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