Predictors of poor clinical outcome of cryptococcal meningitis in HIV-infected patients

The aim of this study was to identify baseline prognostic factors for poor clinical outcome of HIV-associated cryptococcal meningitis. We conducted a trial in Thailand and the USA comparing low- and high-dose concomitant use of amphotericin B and fluconazole for HIV-associated cryptococcal meningiti...

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Main Authors: T. Anekthananon, W. Manosuthi, P. Chetchotisakd, S. Kiertiburanakul, K. Supparatpinyo, W. Ratanasuwan, P. G. Pappas, S. G. Filler, H. A. Kopetskie, T. L. Nolen, A. S. Kendrick, R. A. Larsen
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Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/50161
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-501612018-09-04T04:25:33Z Predictors of poor clinical outcome of cryptococcal meningitis in HIV-infected patients T. Anekthananon W. Manosuthi P. Chetchotisakd S. Kiertiburanakul K. Supparatpinyo W. Ratanasuwan P. G. Pappas S. G. Filler H. A. Kopetskie T. L. Nolen A. S. Kendrick R. A. Larsen Medicine The aim of this study was to identify baseline prognostic factors for poor clinical outcome of HIV-associated cryptococcal meningitis. We conducted a trial in Thailand and the USA comparing low- and high-dose concomitant use of amphotericin B and fluconazole for HIV-associated cryptococcal meningitis to amphotericin B followed by fluconazole. Subjects who were either alive and cerebrospinal fluid (CSF) culture-positive or dead were considered to have a poor outcome. At day 14, baseline characteristics associated with poor outcome included: low weight, high CSF cryptococcal antigen (CrAg) titre and low CSF white blood cell (WBC) count. At day 70, the associated baseline characteristics included: CSF CrAg titre > 1:1024 and low Karnofsky performance status. Overall, consistent with published findings, low weight, high CSF CrAg titre and low CSF WBC counts at baseline were predictors for poor clinical outcome. In addition, we found that low Karnofsky performance status was predictive of poor outcome. Prompt management with appropriate antifungal therapy for this particular group of patients may improve the outcomes. 2018-09-04T04:25:33Z 2018-09-04T04:25:33Z 2011-11-01 Journal 09564624 2-s2.0-81355153736 10.1258/ijsa.2011.010538 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=81355153736&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/50161
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
T. Anekthananon
W. Manosuthi
P. Chetchotisakd
S. Kiertiburanakul
K. Supparatpinyo
W. Ratanasuwan
P. G. Pappas
S. G. Filler
H. A. Kopetskie
T. L. Nolen
A. S. Kendrick
R. A. Larsen
Predictors of poor clinical outcome of cryptococcal meningitis in HIV-infected patients
description The aim of this study was to identify baseline prognostic factors for poor clinical outcome of HIV-associated cryptococcal meningitis. We conducted a trial in Thailand and the USA comparing low- and high-dose concomitant use of amphotericin B and fluconazole for HIV-associated cryptococcal meningitis to amphotericin B followed by fluconazole. Subjects who were either alive and cerebrospinal fluid (CSF) culture-positive or dead were considered to have a poor outcome. At day 14, baseline characteristics associated with poor outcome included: low weight, high CSF cryptococcal antigen (CrAg) titre and low CSF white blood cell (WBC) count. At day 70, the associated baseline characteristics included: CSF CrAg titre > 1:1024 and low Karnofsky performance status. Overall, consistent with published findings, low weight, high CSF CrAg titre and low CSF WBC counts at baseline were predictors for poor clinical outcome. In addition, we found that low Karnofsky performance status was predictive of poor outcome. Prompt management with appropriate antifungal therapy for this particular group of patients may improve the outcomes.
format Journal
author T. Anekthananon
W. Manosuthi
P. Chetchotisakd
S. Kiertiburanakul
K. Supparatpinyo
W. Ratanasuwan
P. G. Pappas
S. G. Filler
H. A. Kopetskie
T. L. Nolen
A. S. Kendrick
R. A. Larsen
author_facet T. Anekthananon
W. Manosuthi
P. Chetchotisakd
S. Kiertiburanakul
K. Supparatpinyo
W. Ratanasuwan
P. G. Pappas
S. G. Filler
H. A. Kopetskie
T. L. Nolen
A. S. Kendrick
R. A. Larsen
author_sort T. Anekthananon
title Predictors of poor clinical outcome of cryptococcal meningitis in HIV-infected patients
title_short Predictors of poor clinical outcome of cryptococcal meningitis in HIV-infected patients
title_full Predictors of poor clinical outcome of cryptococcal meningitis in HIV-infected patients
title_fullStr Predictors of poor clinical outcome of cryptococcal meningitis in HIV-infected patients
title_full_unstemmed Predictors of poor clinical outcome of cryptococcal meningitis in HIV-infected patients
title_sort predictors of poor clinical outcome of cryptococcal meningitis in hiv-infected patients
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=81355153736&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/50161
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