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• Rajasingham R, Smith RM, Park BJ, et al. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. Lancet Infect Dis. 2017. https://doi.org/10.1016/S1473-3099(17)30243-8 The most current and comprehensive global burden of disease estimates for HIV-associated cryptococcal meningitis.
•• Molloy SF, Kanyama C, Heyderman RS, et al. Antifungal combinations for treatment of cryptococcal meningitis in Africa. N Engl J Med. 2018. https://doi.org/10.1056/NEJMoa1710922. The ACTA trial demonstrated the non-inferiority of short-course (one week) amphotericin B plus flucytosine in the treatment of cryptococcal meningitis as well as the effectiveness of fluconazole plus flucytosine, an oral combination regimen.
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Lawrence DS, Youssouf N, Molloy SF, et al. AMBIsome Therapy Induction OptimisatioN (AMBITION): high dose ambisome for cryptococcal meningitis induction therapy in sub-Saharan Africa: study protocol for a phase 3 randomised controlled non-inferiority trial. Trials. 2018;19(649):649.
Jarvis JN, Harrison TS, Lawn SD, Meintjes G, Wood R, Cleary S. Cost effectiveness of cryptococcal antigen screening as a strategy to prevent HIV-associated cryptococcal meningitis in South Africa. PLoS One. 2013;8:e69288. https://doi.org/10.1371/journal.pone.0069288.
• Livermore J, Howard SJ, Sharp AD, et al. Efficacy of an abbreviated induction regimen of amphotericin B deoxycholate for cryptococcal meningoencephalitis: 3 days of therapy is equivalent to 14 days. MBio. 2014;5(1):1–11. https://doi.org/10.1128/mBio.00725-13An animal model study which found no statistically significant difference in cerebral fungal density between rabbits that received daily therapy with amphotericin B and those that received an abbreviated regimen.
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Nussbaum JC, Jackson A, Namarika D, Phulusa J, Kenala J, Kanyemba C, et al. Combination flucytosine and high-dose fluconazole compared with fluconazole monotherapy for the treatment of cryptococcal meningitis: a randomized trial in Malawi. Clin Infect Dis. 2010;50:338–44. https://doi.org/10.1086/649861.
Tenforde MW, Shapiro AE, Rouse B, et al. Treatment for HIV-associated cryptococcal meningitis. Cochrane Database Syst Rev. 2018;2018(7). doi:https://doi.org/10.1002/14651858.CD005647.pub3
• WHO. World Health Organisation Guidelines for the diagnosis, prevention and management of cryptococcal disease in HIV-infected adults, adolescents and children. Guidel Diagnosis, Prev Manag Cryptococcal Dis HIV-Infected Adults, Adolesc Child Suppl to 2016 Consol Guidel Use Antiretrovir Drugs Treat Prev HIV Infect. 2018. The WHO guidelines for the management of HIV-associated cryptococcal meningitis which is the current leading international guidance on screening and treatment.
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Nelson M, Dockrell D, Edwards S. British HIV Association and British Infection Association guidelines for the treatment of opportunistic infection in HIV-seropositive individuals 2011. HIV Med 2011. doi:https://doi.org/10.1111/j.1468-1293.2011.00944_1.x, 12, 1, 5.
Hamill RJ, Sobel JD, El-Sadr W, et al. Comparison of 2 doses of liposomal amphotericin B and conventional amphotericin B deoxycholate for treatment of AIDS-associated acute cryptococcal meningitis: a randomized, double-blind clinical trial of efficacy and safety. Clin Infect Dis. 2010;51:225–32. https://doi.org/10.1086/653606.
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• Lestner J, McEntee L, Johnson A, et al. Experimental models of short courses of liposomal amphotericin b for induction therapy for cryptococcal meningitis. Antimicrob Agents Chemother. 2017. https://doi.org/10.1128/AAC.00090-17 A pharmacokinetic study of liposomal amphotericin B in plasma and cerebrum in cohorts of mice infected with Cryptococcus neoformansdemonstrating a prolonged half-life of circa 133 hours and therefore the potential rationale for high-dose therapy in humans.
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•• Jarvis JN, Leeme TB, Molefi M, et al. Short-course high-dose liposomal amphotericin B for human immunodeficiency virus-associated cryptococcal meningitis: a phase 2 randomized controlled trial. Clin Infect Dis. 2019. doi:https://doi.org/10.1093/cid/ciy515. A phase two trial comparing different high-dose, short-course regimens of liposomal amphotericin B with 14 days of daily dosing. A single, high-dose (10mg/kg) was found to be non-inferior to daily dosing in terms of clearing Cryptococcus from the cerebrospinal fluid. This regimen has been taken forward to a phase III, clinical-endpoint trial.
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•• Govender NP, Meintjes G, Mangena P, et al. Southern African HIV Clinicians Society guideline for the prevention, diagnosis and management of cryptococcal disease among HIV-infected persons: 2019 update. South Afr J HIV Med. 2019. https://doi.org/10.4102/sajhivmed.v20i1.1030 This 2019 guidance from the Southern Africa Clinicians Society incorporates the latest research findings and is currently the most up-to-date guidance on the diagnosis and management of cryptococcal meningitis.
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Identifier NCT03945448, Single dose liposomal amphotericin for asymptomatic cryptococcal antigenaemia. ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). https://doi.org/10.31525/ct1-nct03945448
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Gilead. Gilead sciences announces steep discounts for ambisome to treat cryptococcal meningitis in low - and middle-income countries Company Statement, 2018; (September 7). (PRESS RELEASE) Available at: http://www.gilead.com/news/gilead-sciences-announces-steep-discounts-for-ambisome