title: Recent advances in AIDS-related cryptococcal meningitis treatment with an emphasis on resource limited settings.
abstract: Recent advances in the treatment and prevention of cryptococcal meningitis have the potential to decrease AIDS-related deaths. Areas covered: Targeted screening for asymptomatic cryptococcal antigenemia in persons with AIDS is a cost effective method for reducing early mortality in patients on antiretroviral therapy. For persons with symptomatic cryptococcal meningitis, optimal initial management with amphotericin and flucytosine improves survival compared to alternative therapies; however, amphotsericin is difficult to administer and flucytosine has not been available in middle or low income countries, where cryptococcal meningitis is most prevalent. Expert commentary: Improved care for cryptococcal meningitis patients in resource-limited settings is possible, and new treatment possibilities are emerging.
authors.affiliation: a Division of Infectious Diseases & International Medicine, Department of Medicine , University of Minnesota , Minneapolis , MN , USA.|b Infectious Disease Institute, Makerere University , Kampala , Uganda.
authors.forename: Sarah
authors.initials: S
authors.lastname: Lofgren
authors.affiliation: a Division of Infectious Diseases & International Medicine, Department of Medicine , University of Minnesota , Minneapolis , MN , USA.|b Infectious Disease Institute, Makerere University , Kampala , Uganda.
authors.forename: Mahsa
authors.initials: M
authors.lastname: Abassi
authors.affiliation: a Division of Infectious Diseases & International Medicine, Department of Medicine , University of Minnesota , Minneapolis , MN , USA.|b Infectious Disease Institute, Makerere University , Kampala , Uganda.
authors.forename: Joshua
authors.initials: J
authors.lastname: Rhein
authors.affiliation: a Division of Infectious Diseases & International Medicine, Department of Medicine , University of Minnesota , Minneapolis , MN , USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Boulware
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D000666:Amphotericin B / Q000191:economics / Q000627:therapeutic use*; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000191:economics / Q000627:therapeutic use*; D000946:Antigens, Fungal / Q000097:blood*; D058070:Asymptomatic Diseases; D003362:Cost-Benefit Analysis; D003455:Cryptococcus neoformans / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification; D003906:Developing Countries; D004334:Drug Administration Schedule; D015725:Fluconazole / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D008403:Mass Screening / Q000191:economics; D016919:Meningitis, Cryptococcal / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D020280:Sertraline / Q000191:economics / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D000935:Antifungal Agents; D000946:Antigens, Fungal; D000666:Amphotericin B; D015725:Fluconazole; D020280:Sertraline
keywords: AIDS; CM-IRIS; HIV; antifungal therapy; antiretroviral therapy; cryptococcal meningitis; immune reconstitution inflammatory syndrome; review; sertraline