Primary prophylaxis with fluconazole against systemic fungal infections in HIV-positive patients.
OBJECTIVE
To investigate the efficacy of fluconazole prophylaxis against systemic fungal infections in HIV-positive patients.


METHODS
Open label treatment compared with historical controls.


METHODS
Patients were seen at the Parkland Memorial Hospital HIV Clinic, Dallas, Texas, USA between 1 March 1990 and 28 February 1991.


METHODS
Three hundred and thirty-seven historical controls were followed for 157 patient-years, and 329 fluconazole-treated patients for 145 patient-years.


METHODS
Fluconazole (100 mg daily) was administered to all patients with CD4 lymphocyte counts less than 68 x 10(6)/l seen at our HIV clinic after 1 March 1990.


METHODS
Lysis-centrifugation blood cultures were recorded monthly for all patients during both study periods.


RESULTS
Twenty infections (16 cryptococcosis, four histoplasmosis) occurred in 337 historical reference control patients (product-limit 1-year incidence, 7.5 +/- 2.0/year). Four infections (one cryptococcosis, three histoplasmosis) occurred in the treated patient group (product-limit 1-year incidence, 1.8 +/- 0.9/year).


CONCLUSIONS
Fluconazole warrants further evaluation for prophylaxis against systemic fungal infections in HIV-positive patients.
Division of General Internal Medicine, University of Texas Southwestern Medical Center, Dallas.
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Nightingale
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Cal
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Peterson
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Gamble
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Watson
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Manzone
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Baker
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Jockusch
D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D009181:Mycoses / Q000150:complications / Q000276:immunology / Q000517:prevention & control*; D009894:Opportunistic Infections / Q000150:complications / Q000276:immunology / Q000517:prevention & control*
D015725:Fluconazole