Comparison of amphotericin B deoxycholate, amphotericin B liposome and voriconazole as induction treatment on HIV-related cryptococcal meningitis

Abstract

Abstract: Objective To compare clinical effects between amphotericin B deoxycholate (AmB) + 5 fluorocytosine (5FC) ± fluconazole (Flu), amphotericin B liposome (LipAmB) + 5FC and voriconazole (Vori) + 5FC as induction treatment on HIV-related cryptococcal meningitis.Methods A retrospective cohort study was performed to compare the side effects and 10-week cumulative survival rates in 85 HIV- related cryptococcal meningitis patients who treated with AmB + 5FC ± Flu, LipAmB + 5FC or Vori + 5FC as induction regimens from 2010 to 2017.Result sThe incidences of hypokalemia and creatinine elevation were higher in the AmB + 5FC ± Flu group than in Vori + 5FC group (P=0.016, P=0.047, respectively), but no statistical significance was found in LipAmB + 5FC group vs. Vori + 5FC group, and AmB + 5FC ± Flu vs. LipAmB+5FC group. The 10-week cumulative survival rate of patients was 96.6%, 85.5%, and 76.2% in LipAmB + 5FC group, AmB + 5FC ± Flu group and Vori + 5FC, respectively (Log-Rank P=0.093), and the 10-week cumulative survival rate of patients in LipAmB + 5FC group was higher than those in Vori + 5FC group (Log-Rank P=0.022).Conclusion The Vori + 5FC as induction therapy is not superior to the AmB + 5FC ± Flu or LipAmB + 5FC regimen, but related with less side effects. LipAmB + 5FC as induction therapy is not inferior to the AmB + 5FC ± Flu regimen.

Key words: AIDS, Cryptococcal meningitis, Amphotericin B deoxycholate, Amphotericin B liposome, Voriconazole

TAO Ran, SHI Jin-chuan, GUO Yong-zheng, XU Li-jun, CHEN Ying, LOU Fang-yuan, HUANG Ying, XU Yan, ZHU Biao, CHEN Yao-kai, YU Jian-hua. Comparison of amphotericin B deoxycholate, amphotericin B liposome and voriconazole as induction treatment on HIV-related cryptococcal meningitis[J]. Electronic Journal of Emerging Infectious Diseases, 2019, 4(2): 97-102.

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