Ugandan study supports the use of fluconazole to prevent cryptococcal meningitis
Oral fluconazole prophylaxis safely prevents invasive cryptococcal disease in people with advanced HIV, according to a randomised, double-blind, placebo-controlled trial conducted in over 1500 participants in rural Uganda, and presented on Monday at the Sixteenth Conference on Retrovirus and Opportunistic Infections (CROI) in Montreal. Prophylaxis was effective in people who were waiting to receive antiretroviral therapy (ART) and in those who had recently started ART, but who had not yet had a significant improvement in their immune status. It also significantly reduced the incidence of other serious fungal infections like oesophageal candidiasis.
Corticosteroid therapy improves outcomes in people with TB-IRIS in trial
A four-week course of the anti-inflammatory corticosteroid, prednisone, improves outcomes when given to people who develop tuberculosis (TB)-immune reconstitution inflammatory syndrome (TB-IRIS) after starting antiretroviral therapy (ART) - without causing an excess of steroid side-effects or other infections, according to a randomised placebo-controlled trial conducted in Cape Town, and presented on Monday at the Sixteenth Conference on Retroviruses and Opportunistic Infections in Montreal.
More treatment failure in people on TB treatment who start once daily nevirapine-based ART than efavirenz-based ART
People on TB treatment who started a once-daily antiretroviral therapy (ART) regimen of nevirapine/ddI/3TC were significantly more likely to fail ART than those who started on a once-daily regimen of efavirenz/ddI/3TC, according to a randomised prospective study from Chennai, India. In fact, the nevirapine arm performed so poorly that the study’s Data Safety and Monitoring Board (DSMB) ended accrual to that study arm and closed the study ahead of schedule.