Fluconazole for primary prophylaxis of AIDS-associated cryptococcosis: a case-control study.
In order to verify whether fluconazole has a prophylactive effect against the occurrence of cryptococcosis in HIV-infected patients and to identify other factors capable of increasing or reducing the risk of this infection, we arranged a case-control study of 17 patients with cryptococcal infection. 34 controls were selected, matched by presence of an AIDS-defining event, CD4 cell count, and date of T-cell phenotyping. No significant difference in exposure to fluconazole, in total days of treatment, or in total dose administered was observed between cases and controls. However, control patients took a significantly higher average daily dosage of fluconazole and a linear tendency in risk reduction (p = 0.04) in relation to increasing dosage was observed. Antiretroviral therapy and an average daily fluconazole dose exceeding 150 mg both each reduced the risk of a cryptococcal infection.
Department of Infectious Diseases, Catholic University, Rome, Italy.
A
A
Ammassari
A
A
Linzalone
R
R
Murri
G
G
Marasca
G
G
Morace
A
A
Antinori
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D000946:Antigens, Fungal / Q000032:analysis; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D016022:Case-Control Studies; D003453:Cryptococcosis / Q000150:complications / Q000188:drug therapy*; D003455:Cryptococcus neoformans; D003881:Dermatomycoses / Q000150:complications / Q000188:drug therapy; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D016469:Fungemia / Q000382:microbiology; D006801:Humans; D016130:Immunophenotyping; D008172:Lung Diseases, Fungal / Q000150:complications / Q000188:drug therapy; D008297:Male; D016919:Meningitis, Cryptococcal / Q000150:complications / Q000188:drug therapy
D000935:Antifungal Agents; D000946:Antigens, Fungal; D015725:Fluconazole