Lazar JT, Ksionski GE; International Conference on AIDS.
Int Conf AIDS. 1991 Jun 16-21; 7: 226 (abstract no. W.B.2177).
Vestar, Inc., San Dimas, CA, USA
Cryptococcosis remains a significant cause of morbidity and mortality in patients infected with HIV. Amphotericin B is a mainstay of treatment because of a general lack of pathogen resistance, but its therapeutic efficacy is limited by its toxicity, particularly in patients requiring high doses. AmBisome is a liposomal amphotericin B formulation with greatly reduced toxicity. Nine patients with HIV infection and primary episodes of cryptococcosis were enrolled in a study of AmBisome in cases where amphotericin B was ineffective, toxic or not indicated. Eight patients had cryptococcal meningitis (CCM) and one had both CNS and pulmonary cryptococcosis. CCM was identified by cerebrospinal fluid (CSF) culture in 8 cases and by CSF microscopy and serology in 1. Patients received a maximum of 3.0 mg/kg/day and 50-12,375 mg of AmBisome over 1 - 59 days. One patient died of advanced CCM before a judgment of efficacy could be made. All the remaining 8 patients responded clinically to treatment; 7 (including the case with CCM plus pulmonary cryptococcosis) were clinically cured and 1 was improved. Cryptoccoci were eradicated in 6 of 8 evaluable cases and were cleared from CSF in 7 - 15 days. One patient experienced anemia, thrombocytopenia and hypokalemia that resolved 19 days after the last dose and were not considered unequivocally due to AmBisome. Judgment of the cause of such a reaction is difficult in a patient with poor hematologic function. A second patient experienced rigors hours after dosing on 1 occasion during treatment, and a third patient, experienced occasional transient weakness after dosing. No creatinine or BUN increases, nausea or fever were reported. AmBisome is an effective, well tolerated treatment for primary CCM.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- AmBisome
- Amphotericin B
- Cryptococcosis
- HIV
- HIV Seropositivity
- HIV-1
- Humans
- Meningitis, Cryptococcal
Other ID:
UI: 102192781
From Meeting Abstracts