Kalata, Newton, Ellis, Jayne, Kanyama, Cecilia, Kuoanfank, Charles, Temfack, Elvis, Mfinanga, Sayoki, Lesikari, Sokoine, Chanda, Duncan, Lakhi, Shabir, Nyazika, Tinashe et al (show 11 more authors)
(2021)
Short-term Mortality Outcomes of HIV-Associated Cryptococcal Meningitis in Antiretroviral Therapy-Naive and -Experienced Patients in Sub-Saharan Africa.
OPEN FORUM INFECTIOUS DISEASES, 8 (10).
ofab397-.
ISSN 2328-8957, 2328-8957
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Cryptococcal meningitis in ART experienced patients.pdf - Author Accepted Manuscript Download (492kB) | Preview |
Abstract
<h4>Background</h4>An increasing proportion of patients with HIV-associated cryptococcal meningitis have received antiretroviral therapy (ART) before presentation. There is some evidence suggesting an increased 2-week mortality in those receiving ART for <14 days compared with those on ART for >14 days. However, presentation and outcomes for cryptococcal meningitis patients who have recently initiated ART, and those with virologic failure and/or nonadherence, are not well described.<h4>Methods</h4>Six hundred seventy-eight adults with a first episode of cryptococcal meningitis recruited into a randomized, noninferiority, multicenter phase 3 trial in 4 Sub-Saharan countries were analyzed to compare clinical presentation and 2- and 10-week mortality outcomes between ART-naïve and -experienced patients and between patients receiving ART for varying durations before presentation.<h4>Results</h4>Over half (56%; 381/678) the study participants diagnosed with a first episode of cryptococcal meningitis were ART-experienced. All-cause mortality was similar at 2 weeks (17% vs 20%; hazard ratio [HR], 0.85; 95% CI, 0.6-1.2; <i>P</i> = .35) and 10 weeks (38% vs 36%; HR, 1.03; 95% CI, 0.8-1.32; <i>P</i> = .82) for ART-experienced and ART-naïve patients. Among ART-experienced patients, using different cutoff points for ART duration, there were no significant differences in 2- and 10-week mortality based on duration of ART.<h4>Conclusions</h4>In this study, there were no significant differences in mortality at 2 and 10 weeks between ART-naïve and -experienced patients and between ART-experienced patients according to duration on ART.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Antiretroviral therapy, Cryptococcal meningitis, HIV, Short-term mortality, Sub-Saharan Africa |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 18 Nov 2021 08:29 |
| Last Modified: | 07 Dec 2024 21:23 |
| DOI: | 10.1093/ofid/ofab397 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3143364 |
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