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Cryptococcal meningitis : epidemiology and therapeutic options

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Sloan_2014_JCE_Cryptococcalmeningitis_CC.pdf (675.6Kb)
Date
13/05/2014
Author
Sloan, Derek J.
Parris, Victoria
Keywords
Antifungal therapy
Antiretroviral therapy
Cryptococcosis
HIV
Immune reconstitution inflammatory syndrome
Immunosuppression
RA0421 Public health. Hygiene. Preventive Medicine
RM Therapeutics. Pharmacology
Epidemiology
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Abstract
Cryptococcal meningitis causes morbidity and mortality worldwide. The burden of disease is greatest in middle- and low-income countries with a high incidence of human immunodeficiency virus (HIV infection. Patients taking immunosuppressive drugs and some immunocompetent hosts are also at risk. Treatment of cryptococcal meningitis consists of three phases: Induction, consolidation, and maintenance. Effective induction therapy requires potent fungicidal drugs (amphotericin B and flucytosine, which are often unavailable in low-resource, high-endemicity settings. As a consequence, mortality is unacceptably high. Wider access to effective treatment is urgently required to improve outcomes. For human immunodeficiency virus-infected patients, judicious management of asymptomatic cryptococcal antigenemia and appropriately timed introduction of antiretroviral therapy are important.
Citation
Sloan , D J & Parris , V 2014 , ' Cryptococcal meningitis : epidemiology and therapeutic options ' , Journal of Clinical Epidemiology , vol. 6 , pp. 169-182 . https://doi.org/10.2147/CLEP.S38850
Publication
Journal of Clinical Epidemiology
Status
Peer reviewed
DOI
https://doi.org/10.2147/CLEP.S38850
ISSN
0895-4356
Type
Journal item
Rights
© 2014 Sloan and Parris. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php
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  • University of St Andrews Research
URI
http://hdl.handle.net/10023/13031

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