Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America
Braz. j. infect. dis
;
17(3): 353-362, May-June 2013. ilus, tab
Artigo
em Inglês
| LILACS, SES-SP
| ID: lil-676873
ABSTRACT
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.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Meningite Criptocócica
/
Infecções Oportunistas Relacionadas com a AIDS
/
Terapia Antirretroviral de Alta Atividade
Limite:
Humanos
Idioma:
Inglês
Revista:
Braz. j. infect. dis
Ano de publicação:
2013
Tipo de documento:
Artigo
/
Documento de projeto
Instituição/País de afiliação:
Instituto de Infectologia Emilio Ribas/BR
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