ArticleOpen forum infectious diseases2018
High Mortality in HIV-Associated Cryptococcal Meningitis Patients Treated With Amphotericin B-Based Therapy Under Routine Care Conditions in Africa.
Article in Open forum infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Prevalence of cryptococcal meningitis among people living with human immuno-deficiency virus and predictors of mortality in adults on induction therapy in Africa: A systematic review and meta-analysis.Frontiers in medicine · 2022Pooled it
- Equity in clinical trials for HIV-associated cryptococcal meningitis: A systematic review of global representation and inclusion of patients and researchers.PLoS neglected tropical diseases · 2021Pooled it
- What Is the Most Appropriate Induction Regimen for the Treatment of HIV-Associated Cryptococcal Meningitis When the Recommended Regimen Is Not Available? Evidence From a Network Meta-Analysis.Frontiers in pharmacology · 2020Pooled it
- Mortality from HIV-associated meningitis in sub-Saharan Africa: a systematic review and meta-analysis.Journal of the International AIDS Society · 2020Pooled it
- Under pressure: a call to increase access to spinal manometers as a critical component of the management of cryptococcal meningitis.AIDS (London, England) · 2026Article
- Characteristics of Mortality in HIV-negative Cryptococcosis Patients: Analysis of a Cohort of 743 Patients.Open forum infectious diseases · 2026Article
- Acetylation and accessibility ofCell surface (Amsterdam, Netherlands) · 2026Article
- Outcomes of a 24-month study of patients with HIV with Cryptococcal meningitis on high-dose fluconazole induction in Abidjan, Côte d'Ivoire, between 2012 and 2016.IJID regions · 2025Article
- Review
- Implementation of Single High-dose Liposomal Amphotericin B Based Induction Therapy for Treatment of HIV-associated Cryptococcal Meningitis in Uganda: A Comparative Prospective Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Observational
- Funding for research on cryptococcal disease: an analysis based on the G-finder report.IMA fungus · 2024Article
- Cryptococcal meningitis.Nature reviews. Disease primers · 2023Review
- Six months survival and risk factors for attrition for patients detected with cryptococcal antigenemia through screening in Malawi.PloS one · 2023Article
- Antifungal activity of eumelanin-inspired indoylenepheyleneethynylene againstFrontiers in microbiology · 2023Article
- Reversal of CSF HIV-1 Escape during Treatment of HIV-Associated Cryptococcal Meningitis in Botswana.Biomedicines · 2022Article
- Impact of a Cryptococcal meningitis diagnosis and treatment program at Lira Regional Referral Hospital in rural, Northern Uganda.PLOS global public health · 2022Article
- Delays in Cryptococcal Meningitis Diagnosis and Care: A Mixed Methods Study in Rural Uganda.Annals of global health · 2022Article
- Prevalence and Sequelae of Cryptococcal Antigenemia in Antiretroviral Therapy-Experienced Populations: An Evaluation of Reflex Cryptococcal Antigen Screening in Botswana.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Transcriptomic biomarker pathways associated with death in HIV-infected patients with cryptococcal meningitis.BMC medical genomics · 2021Article
- Cost-effectiveness analysis of flucytosine as induction therapy in the treatment of cryptococcal meningitis in HIV-infected adults in South Africa.BMC health services research · 2021Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundCryptococcal meningitis (CM) causes 10%-20% of HIV-related deaths in Africa. Due to limited access to liposomal amphotericin and flucytosine, most African treatment guidelines recommend amphotericin B deoxycholate (AmB-d) plus high-dose fluconazole; outcomes with this treatment regimen in routine care settings have not been well described.
methodsElectronic national death registry data and computerized medical records were used to retrospectively collect demographic, laboratory, and 1-year outcome data from all patients with CM between 2012 and 2014 at Botswana's main referral hospital, when recommended treatment for CM was AmB-d 1 mg/kg/d plus fluconazole 800 mg/d for 14 days. Cumulative survival was estimated at 2 weeks, 10 weeks, and 1 year.
resultsThere were 283 episodes of CM among 236 individuals; 69% (163/236) were male, and the median age was 36 years. All patients were HIV-infected, with a median CD4 count of 39 cells/mm
conclusionsMortality rates following HIV-associated CM treated with AmB-d and fluconazole in a routine health care setting in Botswana were very high. The findings highlight the inadequacies of current antifungal treatments for HIV-associated CM and underscore the difficulties of administering and monitoring intravenous amphotericin B deoxycholate therapy in resource-poor settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.