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- Title
Efficacy of induction regimens for cryptococcal meningitis in HIV-infected adults: a systematic review and network meta-analysis.
- Authors
Chen, Chang-Hua; Li, Hua; Chen, Hsien-Meng; Chen, Yu-Min; Chang, Yu-Jun; Lin, Pao-Yen; Hsu, Chih-Wei; Tseng, Ping-Tao; Lin, Kai-Huang; Tu, Yu-Kang
- Abstract
Cryptococcal meningitis (CM) is the most fatal adult meningitis in patients with human immunodeficiency virus (HIV). There is no conclusive evidence for the superiority of 1-week amphotericin B deoxycholate (AmphB) + flucytosine (5-FC) regimen over other antifungals in the management of HIV patients with CM (HIV–CM patients). We aimed to evaluate the differences in efficacy and tolerability of different antifungal agents in HIV–CM patients by conducting a current network meta-analysis NMA. Overall, 19 randomized controlled trials were included with 2642 participants. A regimen indicated a possibly lower early mortality rate, namely, AmphB + 5-FC + Azole (OR = 1.1E−12, 95% CIs = 1.3E−41 to 0.06) comparing to AmphB + 5-FC. The current NMA provides evidence that AmphB + 5-FC + Azole are superior to all the investigated treatments for induction regimen in HIV–CM patients.
- Subjects
MENINGITIS; HIV-positive persons; AMPHOTERICIN B; ANTIFUNGAL agents; RANDOMIZED controlled trials
- Publication
Scientific Reports, 2021, Vol 11, Issue 1, p1
- ISSN
2045-2322
- Publication type
Article
- DOI
10.1038/s41598-021-87726-6