A placebo-controlled trial of maintenance therapy with fluconazole after treatment of cryptococcal meningitis in the acquired immunodeficiency syndrome

Article Abstract:

Infections with cryptococcal species, which are yeast-like organisms, are common among patients with AIDS and may account for as many as 13 percent of hospital admissions of AIDS patients. As treatment of other AIDS-related infections improves, cryptococcal infections are likely to become even more important in the clinical picture of AIDS. A number of effective drugs exist to combat cryptococcal meningitis (inflammation of the membranes surrounding the brain), but recurrences are common and the evidence suggests that after the acute meningitis is treated successfully, the patient should be placed on some sort of maintenance therapy to prevent recurrence. Antifungal agents such as amphotericin B, ketoconazole, and itraconazole may be less effective as agents for maintenance, since they penetrate poorly past the blood-brain barrier. Fluconazole, on the other hand, penetrates well into the cerebrospinal fluid and may be a superior agent for maintenance after cryptococcal meningitis. This hypothesis was tested in randomized, placebo-controlled trial of fluconazole in the maintenance therapy of 61 AIDS patients who had been successfully treated for cryptococcal meningitis. Thirty-four patients in the treatment group received 200 milligrams fluconazole every day indefinitely, while 27 patients received placebo only. Ten of the 27 patients receiving placebo experienced recurrent cryptococcal infection. In four of these cases there were recurrent meningeal infections. A single recurrence among the 34 patients receiving fluconazole did not involve the meninges. The results suggest that without maintenance therapy recurrent infection is common among AIDS patients recovering from cryptococcal meningitis. However, fluconazole is extremely effective in preventing such recurrent infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Complications and side effects, Cryptococcal infections, Meningitis, Cryptococcosis, AIDS (Disease), Fluconazole

---

Recovery of human immunodeficiency virus type 1 from semen: minimal impact of stage of infection and current antiviral chemotherapy

Article Abstract:

Human immunodeficiency virus type 1 (HIV) is the sexually transmitted virus that causes AIDS. (HIV can also be transmitted by other means, such as contaminated needles.) HIV has been isolated from the semen of men who have HIV infection. The presence of antibodies against HIV in an individual's blood is a positive indication of HIV infection, and the person is considered to be seropositive. The presence of HIV in semen was assessed in 55 semen samples from 34 men who were seropositive for HIV infection. HIV was found in 6 of 19 semen samples from asymptomatic men (men with HIV infection, but without symptoms), and 10 of 36 semen samples from symptomatic men (men with HIV infection and symptoms). HIV was found in approximately 30 percent of all semen samples tested regardless of the stage or severity of HIV infection. There was no relation between the identification of HIV in semen and the numbers of affected T lymphocytes (blood cells that are attacked by HIV) in the seropositive men. In another study group, HIV was isolated in semen from 7 of 30 seropositive men (23 percent) who were not receiving chemotherapy with zidovudine, and in 9 of 22 HIV-infected men (41 percent) who were being treated with zidovudine. These findings demonstrate that HIV infection is associated with the presence of HIV in semen, and that HIV is present in semen regardless of the stage of HIV infection and treatment with zidovudine. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Physiological aspects, HIV infection, HIV infections, HIV (Viruses), HIV, Disease transmission, Identification and classification, Semen

---

Similar abstracts:

• Abstracts: A pilot study of low-dose zidovudine in human immunodeficiency virus infection. Plasma viremia in human immunodeficiency virus infection
• Abstracts: Allogeneic bone marrow transplantation, zidovudine, and human immunodeficiency virus type 1 (HIV-1) infection
• Abstracts: CD4 counts as predictors of opportunistic pneumonias in human immunodeficiency virus (HIV) infection. Lack of clinical utility of cytomegalovirus blood and urine cultures in patients with HIV infection
• Abstracts: The safety and efficacy of zidovudine (AZT) in the treatment of subjects with mildly symptomatic human immunodeficiency virus type 1 (HIV) infection
• Abstracts: A Phase I evaluation of the safety and immunogenicity of vaccination with recombinant gp160 in patients with early human immunodeficiency virus infection

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.