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Braz. j. infect. dis ; 17(3): 353-362, May-June 2013. ilus, tab
Artigo em Inglês | LILACS, SES-SP | ID: lil-676873

RESUMO

Latin America is the region with the third most AIDS-related cryptococcal meningitis infections globally. Highly active antiretroviral therapy (HAART) has reduced the number of infections; however, the number of deaths and the case-fatality rate continues to be unacceptable. In this review, we focus on the burden of AIDS-related cryptococcosis in Latin America and discuss potential strategies to reduce early mortality from Cryptococcus. In this review, we highlight the importance of: (1) earlier HIV diagnosis and HAART initiation with retention-in-care to avoid AIDS; (2) pre-HAART cryptococcal antigen (CRAG) screening with preemptive fluconazole treatment; (3) better diagnostics (e.g. CRAG testing); and (4) optimal treatment with aggressive management of intracranial pressure and induction therapy with antifungal combination. Implementation of these strategies can reduce cryptococcal-related deaths, improve care, and reduce healthcare costs.


Assuntos
Humanos , Infecções Oportunistas Relacionadas com a AIDS/mortalidade , Terapia Antirretroviral de Alta Atividade , Meningite Criptocócica/mortalidade , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Antifúngicos/uso terapêutico , América Latina/epidemiologia , Meningite Criptocócica/tratamento farmacológico
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