Primary prophylaxis with fluconazole against systemic fungal infections in HIV-positive patients

作者：Stephen D. Nightingale, Stanley X. Cal, Dolores M. Peterson, Scott D. Loss, Bradford A. Gamble, Durward A. Watson, Christopher P. Manzone, Judith E. Baker, Jonathan D. Jockusch · 发表于：AIDS · 年份：1992 · DOI：10.1097/00002030-199202000-00008 · 被引用次数：91 · 研究领域：Fungal Infections and Studies、Antifungal resistance and susceptibility、Nail Diseases and Treatments

OBJECTIVE: To investigate the efficacy of fluconazole prophylaxis against systemic fungal infections in HIV-positive patients. DESIGN: Open label treatment compared with historical controls. SETTING: Patients were seen at the Parkland Memorial Hospital HIV Clinic, Dallas, Texas, USA between 1 March 1990 and 28 February 1991. PATIENTS, PARTICIPANTS: Three hundred and thirty-seven historical controls were followed for 157 patient-years, and 329 fluconazole-treated patients for 145 patient-years. INTERVENTIONS: Fluconazole (100 mg daily) was administered to all patients with CD4 lymphocyte counts less than 68 x 10(6)/l seen at our HIV clinic after 1 March 1990. MAIN OUTCOME MEASURES: Lysis-centrifugation blood cultures were recorded monthly for all patients during both study periods. RESULTS: Twenty infections (16 cryptococcosis, four histoplasmosis) occurred in 337 historical reference control patients (product-limit 1-year incidence, 7.5 +/- 2.0/year). Four infections (one cryptococcosis, three histoplasmosis) occurred in the treated patient group (product-limit 1-year incidence, 1.8 +/- 0.9/year). CONCLUSIONS: Fluconazole warrants further evaluation for prophylaxis against systemic fungal infections in HIV-positive patients.